Advances in Mammographic Technique: DBT and CEM (2025)-WEB08-2025

Video Transcription

Video Summary

This webinar covered advances in mammographic techniques, focusing on digital breast tomosynthesis (DBT) and contrast-enhanced mammography (CEM). Dr. Katarina Doddleson reviewed mammographic screening's proven mortality reduction, highlighting limitations of conventional 2D mammography due to tissue overlap, especially in dense breasts. DBT, an FDA-approved quasi-3D imaging method, addresses this by acquiring low-dose X-ray images at multiple angles, improving cancer detection rates by 1-2 additional cancers per 1,000 women screened and reducing false positives and recalls. Synthetic mammography, a reconstructed 2D image from DBT data, minimizes radiation dose while maintaining diagnostic accuracy. However, DBT requires longer interpretation times and greater data storage. Dr. Jose Nett discussed implementing CEM, which combines contrast injection with mammography to exploit tumor neoangiogenesis, offering sensitivity comparable to MRI but with better accessibility and patient tolerance. CEM enhances cancer detection, especially in dense breasts, and aids diagnosis and treatment response monitoring. Challenges include managing IV contrast administration, training, and dealing with artifacts. While CEM shows promise in screening and diagnostics, limitations remain, such as radiation exposure, false positives, and certain lesion detection. Both DBT and CEM represent significant advances, improving early cancer detection and diagnostic confidence, thereby potentially reducing morbidity and mortality from breast cancer. Further long-term data are awaited to confirm sustained mortality benefits.

Keywords

digital breast tomosynthesis

contrast-enhanced mammography

mammographic screening

dense breasts

cancer detection

synthetic mammography

false positives

tumor neoangiogenesis

breast cancer mortality