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Abstract Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide. About half the breast cancer cases and 60% of the deaths are estimated to occur in economically developing countries. Most breast cancer deaths are due to advanced cancer, diagnosed when metastases have already disseminated to lymph nodes or distant organs. The assumption underlying breast cancer screening is that screening will detect potentially life-threatening cancers at an early stage, before they metastasize. Logically, screening is expected to reduce the incidence of advanced cancer, followed by a reduction in breast cancer mortality. Mammography is the only imaging modality that has been shown to reduce mortality from breast cancer through screening and early detection, but it is an imperfect tool with an overall sensitivity of 75%–85%. Specificity is limited; positive predictive value is of 25%–45% range. For staging, sensitivity may be even poorer, with missed multifocal or multicentric disease resulting in incorrect treatment options being offered to the patient. Contrast enhanced digital mammography is a new advanced application of full-field digital mammography enabling the detection of angiogenesis in breast carcinoma. This new breast imaging method can be easily implemented clinically using a current digital mammography system with minor adaptations and commercially available iodinated contrast agent. CEDM should be a useful adjunct to diagnostic mammography and a promising problem-solving and staging tool. |