الفهرس 
Anatomy of the breastOnly 14 pages are availabe for public view
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Abstract
reast cancer is the most common cancer in women
worldwide, breast cancer incidence rates have increased
20% and mortality rates have increased 14%.
It is important to find an accurate and cost-effective way
to detect and diagnose early breast cancers in women across
various ages, races, risk levels and economic levels.
Screening mammography is currently the only qualityassured
and evidence-based method for the early detection of
breast cancer. Breast masses appear as areas of increased
density on mammograms; however it misses many tumors in
dense glandular tissue. Therefore, improvements of
mammography are desirable.
Breast cancers have been shown to enhance with
iodinated contrast agents at computed tomography (CT) and
with gadolinium-based contrast agents at magnetic resonance
(MR) imaging, however breast CT results in a high radiation
dose to the breast and chest wall
Contrast enhancement with Gd-DTPA is essential in
identifying breast cancers and distinguishing malignancies from
benign findings. The disadvantages of MRI include the expense
and the high sensitivity, which results in many unnecessary
biopsies. Contrast-enhanced mammography enables visualization
of tumors without interference from superimposed structures. It
involves injecting the contrast agent intravenously while the
patient is imaged with a sequence of digital mammograms that
show the flow of the contrast agent over time.
Contrast-enhanced digital mammography is used for
detection of angiogenesis by following contrast agent uptake in
suspicious breast lesions.
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.
Two basic CEDM techniques are under development:
temporal subtraction and dual-energy techniques, both
techniques have been studied independently.
CEDM advantages include: Easy procedure that takes
minutes to perform, useful in patients with dense breast
tissue, results can be given to the patient the same day as her
exam, reducing her anxiety, allows doctors to find growing
numbers of small blood vessels, which could be the start of
a tumor and Can be performed on patients who could not
undergo MRI scanning
The main disadvantage of the technique is the need of
administration of contrast material and another disadvantage compared with MRI is that CEDM is an irradiating
technique. However, the dose delivered to the patient is
approximately equivalent to two conventional
mammography views radiation.
from this review we concluded that CEDM is a useful
adjunct to diagnostic mammography and a promising problemsolving
and staging tool and may provide a cost-effective
alternative to breast MRI for some clinical indications..