Contrast-Enhanced Mammography (CEM)

Contrast-Enhanced Mammography (CEM) is an advanced breast imaging examination that helps radiologists see areas of breast tissue in greater detail. By combining mammography with a contrast agent, CEM can provide additional information that may not be visible on standard breast imaging alone.

For some patients, this means greater clarity, fewer unanswered questions, and a quicker path to the next step in care.

Why Might My Doctor Recommend CEM?

Your physician may refer you for CEM when more information is needed following breast imaging.

CEM may be recommended when:

• Additional assessment is needed after a mammogram or ultrasound
• Dense breast tissue makes findings more difficult to evaluate
• A breast abnormality requires further investigation
• The extent of a newly diagnosed breast cancer needs to be assessed
• Breast MRI is not suitable or available

CEM is a diagnostic examination and is not currently used as a routine screening test.

What Happens During the Examination?

The examination is similar to a standard mammogram but includes a small intravenous (IV) injection of an iodine-based contrast agent.

Your appointment will typically include:

• Placement of a small IV line in your arm
• Administration of the contrast agent
• A brief waiting period of approximately two minutes
• Mammography images taken in the same way as a standard mammogram

The imaging itself usually takes 7–10 minutes, with a total appointment time of approximately 30–45 minutes.

What Will I Feel?

Most patients tolerate CEM very well.

After receiving the contrast agent, you may briefly experience:

• A warm or flushed sensation
• A metallic taste in your mouth
• A temporary feeling of needing to urinate

These sensations are usually mild and pass quickly.

What Are the Benefits of CEM?

For appropriate patients, CEM may provide:

• Improved visibility of abnormalities within dense breast tissue
• Greater diagnostic confidence in selected cases
• Faster clarification of findings that require further assessment
• A shorter examination time than breast MRI
• An alternative option for patients who cannot undergo MRI
• Access to advanced breast imaging without leaving Bermuda

For many patients, the greatest benefit is obtaining answers sooner and reducing uncertainty during what can be a stressful time.

Is CEM Safe?

Before your examination, our team will review your medical history and discuss any factors that may affect the use of contrast, including:

• Previous reactions to contrast agents
• Kidney disease or reduced kidney function
• Diabetes
• High blood pressure
• Possible pregnancy

Additional blood work may occasionally be required before the examination.

As with any medical imaging procedure, there are risks and benefits that will be discussed with you. Radiation exposure remains within accepted safety guidelines.

Do I Need a Referral?

Yes. CEM requires a physician referral and is performed only when clinically appropriate.

As part of BCHC's coordinated breast imaging programme, referrals may be reviewed by our radiology team to ensure each patient receives the most appropriate imaging examination.

Questions?

If you have questions about Contrast-Enhanced Mammography or an upcoming appointment, our Diagnostic Imaging team is here to help.

Diagnostic Imaging Department
Bermuda Cancer and Health Centre
Phone: (441) 236-1001
Email: dinfo@chc.bm

Bringing advanced breast imaging closer to home.

Bermuda Cancer and Health Centre is committed to providing equitable access to high-quality cancer screening, diagnosis, and care for everyone in Bermuda.