Interview

What are some of the biggest challenges today in terms of breast cancer imaging for early detection?

Breast cancer is the most common cancer in women worldwide. But fortunately, it is highly treatable if detected early. One of the biggest challenges is making sure women get their resolve mammograms.

Fear is a common reason for putting off routine screenings, hence raising awareness and education of screening is an important topic. In addition, many women had their screening postponed during the pandemic. Greater education is also needed to encourage higher-risk women to discuss the need for screening with their doctors, such as ultrasound, magnetic resonance imaging (MRI), or contrast-enhanced mammography (CEM).

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In what cases might conventional mammography not be enough for certain patients?

Women with high breast density – more glandular tissue, less fat – face an increased risk of developing breast cancer. Detecting tumors with standard x-ray mammography in women with dense breast tissue can be difficult. Contrast-enhanced imaging acts like “lamps” by highlighting the blood vessels that are present in growing tumors.

The European Society of Breast Imaging issued a recommendation in 2022 that women with extreme breast density get breast MRI as screening and also recommended a more personalized approach.

In addition ?Organizations like the American Cancer Society recommend that women who are at?high risk?for breast cancer should get a mammogram plus additional screening every year with MRI.

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Is CEM a new modality? How does it work?

Contrast-enhanced mammography was introduced in 2011 and has gained more traction in the past couple of years. It is a highly sensitive, quick, and relatively low-cost exam that can be easily performed in conjunction with a routine mammogram. It is not very different from a standard digital mammogram, in that positioning and compression of the breast are?the same. But just a few minutes beforehand, a contrast agent is injected into the veins and images are acquired using the same protocol as a mammogram. The whole examination takes around 10 minutes.

Though CEM is not a replacement for MRI, it is a valuable tool when MRI is unavailable or contraindicated, e.g., in patients with claustrophobia.

In addition, Contrast-enhanced mammography can help in facilitating the workflow and also solve the bottle neck of MRI unavailability.

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How do physician and patient education factor into the adoption of CEM??

Education about early detection and imaging options has always been a key factor in fighting breast cancer. As scientific research grows supporting the diagnostic value of CEM, its use will likely increase.

Besides our ongoing educational efforts for healthcare professionals and patients, Bayer has launched a global digital information hub to encourage women to take an active role and make informed decisions about their health:?letstalkaboutit.bayer.com

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What do the different options mean for women undergoing breast imaging?

In a word, it means solutions. When conventional mammography might not be enough, every supplemental imaging is valuable. Breast MRI is a potential solution for women with dense breasts, and CEM represent a potential solution for women who cannot or do not have the accessibility to undergo MRI; a solution for providers in certain regions who cannot offer patients MRI and for over-stretched hospitals, a solution to bottlenecks when patients cannot afford to wait. At the end of the day, it’s all about having more options to give patients clear answers about their health.