Contrast Enhanced Spectral Mammography

The Contrast Enhanced Spectral Mammography procedure is the newest breast imaging procedure to aid in the detection of breast cancer. Carolina Breast Imaging Specialists is one of only a few facilities in the United States to offer this innovative tool in early detection. Dr. Schroeder is one of the leading pioneers of this technique and has been using this tool since its approval in 2012 when he was able to bring CESM to Greenville, making it the second city in the U.S. after Beverly Hills, CA.

Contrast Enhanced Spectral Mammography (CESM) is a special type of mammogram that is performed after an IV injection of X-ray contrast (iodine). CESM shows all of the information of a regular mammogram but also shows areas of increased blood supply. Breast cancer typically has a greater blood supply than normal tissue so it is highlighted on the images.

This procedure, performed by our experienced staff, has been a useful tool in patients in need of imaging in addition to standard mammography and ultrasound.  For example, if a biopsy shows cancer, it is often helpful to get further imaging to make sure the size and extent of the tumor is known to the surgeon before surgery.  This has been typically done with MRI but if MRI is not possible or not desired then CESM may be a good choice.  CESM has also been helpful if mammogram/ultrasound are inconclusive and may have a role in women after lumpectomy or those with dense breast tissue, which limits cancer detection.

How Should I Prepare for My Exam?

There are special requests for patients in preparation for the CESM. Because of the contrast injection, it is necessary to be on a clear liquid diet for 4 hours prior to the exam. Just as with all mammogram exams, it is most comfortable for you to wear a two-piece outfit that you can easily remove your top. Please do not apply deodorant on the day of the exam.