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Background and purpose: Recent metanalyses indicate high diagnostic performance for contrast enhanced mammography (CEM), with sensitivity >90%. We reviewed cancer cases examined with CEM to identify false negative results and possible causes. Methods: 516 patients underwent CEM over 5 months at a single clinic with 22 cases of malignancy diagnosed. The mammographic images, CEM technique, tumour size and histology were reviewed for those with no abnormal CEM enhancement. Results: Review identified 4 false negative cases. CEM technique and mammographic positioning were adequate for all, but in 1 case the region of interest was deep and not included on the CC view, and in 1 case the malignancy was mammographically occult. While invasive carcinoma was present in all cases, the disease was predominantly in situ in 2 cases.Tabled 1Patient Age Menopausal StatusBreast DensityOther RisksBackground ParenchymalEnhancement2D/3D FindingsHistology41PreDNilMinimal9mm calcifications 305:94–103 • https://doi.org/10.1148/radiol.21253
Kunduri et al. (Sat,) studied this question.