Radiation Research Methods with Contrast Enhancement in the Diagnosis of Breast Cancer: Literature Review
https://doi.org/10.37174/2587-7593-2026-9-1-60-68
Abstract
This article summarizes the results of modern scientific research on the use of three imaging methods for the diagnosis of breast cancer: dual-energy contrast spectral mammography (CESM), magnetic resonance imaging with contrast enhancement (MRI) and ultrasound with contrast (CEUS). The authors analyzed the diagnostic capabilities and overall effectiveness of these methods. Based on the analysis, it is concluded that further studies comparing CESM, MRI and CEUS in the same patient group are necessary. This will allow us to better understand how these methods affect treatment planning, therapy selection, and achieving positive clinical results.
About the Authors
N. A. Chekina
Branch A.S. Loginov Moscow Clinical Scientific Center “Mammology Сenter”
Russian Federation
Competing Interests:
Russian Federation
86, Entuziastov Highway, Moscow, 111123
Competing Interests:
Not declared.
A. B. Afanasyev
Branch A.S. Loginov Moscow Clinical Scientific Center “Mammology Сenter”
Russian Federation
Competing Interests:
Russian Federation
86, Entuziastov Highway, Moscow, 111123
Competing Interests:
Not declared.
A. B. Abduraimov
Branch A.S. Loginov Moscow Clinical Scientific Center “Mammology Сenter”
Russian Federation
Competing Interests:
Russian Federation
86, Entuziastov Highway, Moscow, 111123
Competing Interests:
Not declared.
A. K. Andronov
Branch A.S. Loginov Moscow Clinical Scientific Center “Mammology Сenter”
Russian Federation
Competing Interests:
Russian Federation
86, Entuziastov Highway, Moscow, 111123
Competing Interests:
Not declared.
References
1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLO BOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-249. https://doi.org/10.3322/caac.21660.
2. Gradishar WJ, Moran MS, Abraham J, et al. Breast Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2024;22:331-357. https://doi.org/10.6004/jnccn.2024.0035. PMID: 39019058.
3. Malignant neoplasms in Russia in 2023 (morbidity and mortality) еd. by AD Kaprin et al. Moscow, 2024. 276 p. (In Russ.).
4. Gazhonova VE, Zubarev AV, Pulatova IZ. Innovative approaches in the diagnosis of focal formations of the breast category BI-RADS 3-4: the role prospects of integrating ultrasound with contrasting and elastography. REJR 2025;15(1):107-18. (In Russ.). https://doi.org/10.21569/2222-7415-2025-15-1-107-118.
5. Spear G, Lee K, DePersia A, et al. Updates in Breast Cancer Screening and Diagnosis. Curr Treat Options Oncol 2024;25:1451-1460. https://doi.org/10.1007/s11864-024-01271-8. PMID: 39466539.
6. Andronov AK, Abduraimov AB. Role of Contrast-Enhanced Spectral Mammography in the detection of breast cancer. Medical Imaging. 2023;27(4):81-91. (In Russ.). https://doi.org/10.24835/1607-0763-1281.
7. Siu AL. Screening for breast cancer: U.S. Preventive services task force recommendation statement Ann Intern Med. 2016;164:279-296. https://doi.org/10.7326/M15-2886. PMID: 26757170.
8. Boyd NF, Guo H, Martin LJ, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007;356(3):227-36. https://doi.org/10.1056/NEJMoa062790. PMID: 17229950.
9. Yagiyan L, Koldits GA, Rosner B. Mammographic density of the breast and risk breast cancer: relationship of percentage density, absolute density and loose areas with risk factors for breast cancer. Research and Treatment of Breast Cancer. 2015;150:181-189. (In Russ.).
10. Suleimenova DM, et al. Breast cancer in young women: adapted recommendations for radiation examination. International Journal of Applied and Fundamental Research. 2021;3:46-52. (In Russ.) https:// doi.org/10.17513/mjpfi.13190. URL: https://applied-research.ru/ru/article/view?id=13190.
11. Sartor H, Zackrisson S, Elebro K, et al. Mammographic density in relation to tumor biomarkers, molecular subtypes, and mode of detection in breast cancer. Cancer Causes Control. 2015;26(6):931-9. https://doi.org/10.1007/s10552-015-0576-6. PMID: 25860114.
12. Sung H, Ren J, Li J, et al. Breast cancer risk factors and mammographic density among high-risk women in urban China. NPJ Breast Cancer. 2018;4(1):3. https://doi.org/10.1038/s41523-018-0055-9. PMID: 29423438.
13. Kuhl CK. The changing world of breast cancer: a Radiologistʼs perspective. Plast Surg Nurs. 2016;36:31-49. https://doi.org/10.1097/PSN.0000000000000128. PMID: 26933985.
14. Korablev RV, Vasilyev AG. Neoangiogenesis and tumor growth. Russian Biomedical Research. 2020;2(4):3-10. (In Russ.). https://ojs3.gpmu.org/index.php/biomedical-research/article/view/544].
15. Bazhenova DA, Mershina EA, Puchkova OS, et al. A modern view of the principles of breast cancer diagnosis according to contrast mammography (literature review). Medical Imaging. 2022;26(1):40 47. (In Russ.). https://doi.org/10.24835/1607-0763-1090.
16. Chernaya AV, Ulyanova RH, Krivorotko PV, et al. Opportunities contrast spectral dual-energy mammography in the diagnosis of multicentric breast cancer. Tumors of the Female Reproductive System. 2021;17(4):20-28. (In Russ.). https://doi.org/10.17650/1994-4098-2021-17-4-20-28.
17. Suter MB, Pesapane F, Agazzi GM, et al. Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis. Breast. 2020;53:8-17. https://doi.org/10.1016/j.breast.2020.06.005. PMID: 32540554.
18. Gilbert FJ, Pinker-Domenig K. Diagnosis and Staging of Breast Cancer: When and How to Use Mammography, Tomosynthesis, Ultrasound, Contrast-Enhanced Mammography, and Magnetic Resonance Imaging. Springer, 2019;155-66. https://doi.org/10.1007/978-3-030-11149-6.
19. Zeeshan M, Salam B, Khalid QSB et al.. Diagnostic Accuracy of Digital Mammography in the Detection of Breast Cancer. Cureus. 2018;10(4):e2448. https://doi.org/10.7759/cureus.2448. PMID: 29888152
20. Chernaya AV, Ulyanova RH, Bagnenko SS, et al. Contrast-enhanced spectral dual-energy mammography is an accurate diagnostic tool for detecting cancer in dense breast tissue. Medical Imaging. 2023;27(1):25-34. (In Russ.). https://doi.org/0.24835/1607-0763-1152.
21. Sudhir R, Sannapareddy K, Potlapalli A, Krishnamurthy PB, Buddha S, Koppula V. Diagnostic accuracy of contrast-enhanced digital mammography in breast cancer detection in comparison to tomosynthesis, synthetic 2D mammography and tomosynthesis combined with ultrasound in women with dense breast. Br J Radiol. 2021;94(1118):2020-1046. https://doi.org/10.1259/bjr.20201046. PMID: 33242249.
22. Daniaux M, De Zordo T, Santner W, et al. Dual-energy contrast-enhanced spectral mammography (CESM). Arch. Gynecol. Obstet.2015;292(4):739-47. https://doi.org/10.1007/s00404-015-3693-2. PMID: 25814297.
23. Bonfiglio R, Scimeca M, Toschi N, Pistolese CA, Giannini E, Antonacci C, et al. Radiological, histological and chemical analysis of breast micro calcifications: diagnostic value and biological significance. J Mammary Gland Biol Neoplasia 2018;23(1-2):89-99. https://doi.org/10.1007/s10911-018-9396-0. PMID: 29744755.
24. Nori J, Kaur M. Contrast-Enhanced Digital Mammography (CEDM). Springer. 2019. Р.18-19. https://doi.org/10.1007/978-3-319-94553-8.
25. Tabar L, Chen TH-H, Yen AM-F, et al. Effect of Mammography Screening on Mortality by Histological Grade. Cancer Epidemiology Biomarkers & Prevention. 2018;27(2):154-7. https://doi.org/10.1158/1055-9965.EPI-17-0487. PMID: 29150482.
26. Manikhas GM, Safronova OB, Khudjakova TG, et al. Stereotactic biopsy of breast lesions under X-ray control. Journal of Modern Oncology. 2015;17(2):40-4. https://modernonco.orscience.ru/1815-1434/article/view/27006 (In Russ.).
27. Mazo ML, Rozhkova NI, Prokopenko SP, et al. Diagnostics of Breast Lesions. A Fine-Needle Aspiration Biopsy or a Core-Biopsy? Medical Imaging. 2015;(4):79-86. (In Russ.).
28. Wernli KJ, DeMartini WB, Ichikawa L, et al. Breast Cancer Surveillance Consortium. Patterns of breast magnetic resonance imaging use in community practice. JAMA Intern. Med. 2014;174(1):125-32. https:// doi.org/10.1001/jamainternmed.2013.11963. PMID: 24247555.
29. Knopp MV, Weiss E, Sinn HP, et al Pathophysiologic basis of contrast enhancement in breast tumors. J Magn Reson Imaging. 1999;10(3):260-6. https://doi.org/10.1002/(sici)1522-2586(199909)10:3<260::aid-jmri6>3.0.co;2-7. PMID: 10508285.
30. Kuhl CK, Schrading S, Strobel K, et al. Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2014;32(22):2304-10. https://doi.org/10.1200/JCO.2013.52.5386. PMID: 24958821.
31. Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature 2000;407(6801):249-57. https://doi.org/10.1038/35025220. PMID: 11001068.
32. Mus RD, Borelli C, Bult P, et al. Time to enhancement derived from ultrafast breast MRI as a novel parameter to discriminate benign from malignant breast lesions. Eur J Radiol. 2017;89:90-6. https://doi.org/10.1016/j.ejrad.2017.01.020. PMID: 28267555.
33. Onishi N, Kataoka M, Kanao S, et al. Ultrafast dynamic contrast-enhanced MRI of the breast using compressed sensing: breast cancer diagnosis based on separate visualization of breast arteries and veins. J Magn Reson Imaging. 2018;47(1):97-104. https://doi.org/10.1002/jmri.25747. PMID: 28556576.
34. Mann RM, Cho N, Moy L. Breast MRI: State of the Art. Radiology. 2019;292(3):520-36. https://doi.org/10.1148/radiol.2019182947. PMID: 31361209.
35. Bozzini A, Nicosia L, Pruneri G, et al. Clinical performance of contrast-enhanced spectral mammography in presurgical evaluation of breast malignant lesions in dense breasts: a single center study. Breast Cancer Res. Treat. 2020;184(3):723-31. https://doi.org/10.1007/s10549-020-05881-2. PMID: 32860166.
36. Bakker MF, de Lange SV, Pijnappel RM, et al. Supplemental MRI screening for women with extremely dense breast tissue. N Engl J Med. 2019;381:2091-102. https://doi.org/10.1056/NEJ-Moa1903986. PMID: 31774954.
37. Pan J, Tong W, Luo J, Liang J, Pan F, Zheng Y, Xie X. Does contrast-enhanced ultrasound (CEUS) play a better role in diagnosis of breast lesions with calcification? A comparison with MRI. Br J Radiol. 2020;93(1112):20200195. https://doi.org/10.1259/bjr.20200195.
38. Ainakulova AS, Kaidarova DR, Zholdybay Zh, et al. Comparative analysis of contrast-enhanced spectral mammography and breast MRI (literature review). Bulletin of KazNMU. 2020;2:135-9. (In Russ.).
39. van Nijnatten TJA, Morscheid S, Baltzer PAT, et al. Contrast-enhanced breast imaging: Current status and future challenges. Eur J Radiol. 2024;171:111-312. https://doi.org/10.1016/j.ejrad.2024.111312. PMID: 38237520.
40. Kuczek DE, Larsen AMH, Thorseth ML, et al. Collagen density regulates the activity of tumor-infiltrating T cells. J Immunother Cancer. 2019;7(1):68. https://doi.org/10.1186/s40425-019-0556-6. PMID: 30867051.
41. James JR, Pavlicek W, Hanson JA, et al. Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography. Am J Roentgenol. 2017;208(2):362-72. https://doi.org/10.2214/AJR.16.16743. PMID: 28112559.
42. Hobbs MM, Taylor DB, Buzynski S, Peake RE. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEM RI): patient preferences and tolerance. J Med Imaging Radiat Oncol. 2015;59(3):300-5. https://doi.org/10.1111/1754-9485.12296. PMID: 25900704.
43. Kim EY, Youn I, Lee KH, et al. Diagnostic value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer. J Breast Cancer. 2018;21(4):453-62. https://doi.org/10.4048/jbc.2018.21.e62. PMID: 30607168.
44. Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma. Radiology. 2013;266(3):743-51. https://doi.org/10.1148/radiol.12121084. PMID: 23220903.
45. Taylor DB, Burrows S, Saunders CM, et al. Contrast-enhanced mammography (CEM) versus MRI for breast cancer staging: detection of additional malignant lesions not seen on conventional imaging. Eur Radiol Exp. 2023;7(1):8. https://doi.org/10.1186/s41747-022-00318-5. PMID: 36781808 PMCID.
46. Westwood M, Joore M, Grutters J, et al. Contrast-enhanced ultra sound using SonoVue® (sulphur hexafluoride microbubbles) compared with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging for the characterisation of focal liver lesions and detection of liver metastases: a systematic review and cost-effectiveness analysis. 2013;17(16):1-243. https:// doi.org/10.3310/hta17160. PMID: 23611316.
47. Jian Liu, Xiaoling Liu, Jiao He, et al. Percutaneous contrast-enhanced ultrasound for localization and diagnosis of sentinel lymph node in early breast cancer. Sci Rep. 2019;9(1):13545. https://doi.org/10.1038/s41598-019-49736-3. PMID: 31537856.
48. Vovdenko S, Ali S, Ali H, et al. Contrast-enhanced ultrasound (CEUS) as a follow-up method after the focal treatment of renal tumors: systematic review and meta-analysis. Int Urol Nephrol. 2024;56(11):3415-26. https://doi.org/10.1007/s11255-024-04102-9. PMID: 38851652.
49. Boca Bene I, Dudea SM, Ciurea AI. Contrast-enhanced ultrasonography in the diagnosis and treatment modulation of breast cancer. J Pers Med. 2021;11(2):81. https://doi.org/10.3390/jpm11020081. PMID: 33573122.
50. Xu HX. Contrast-Enhanced ultrasound: the evolving applications. World J Radiol. 2009;1(1):15-24. https://doi.org/10.4329/wjr.v1.i1.15. PMID: 21160717.
51. Xiao X, Dong L, Jiang Q, et al. Incorporating Contrast-Enhanced Ultra sound into the BI-RADS Scoring System Improves Accuracy in Breast Tumor Diagnosis: A Preliminary Study in China. Ultrasound Med. Biol. 2016;42(11):2630-8. https://doi.org/10.1016/j.ultrasmed-bio.2016.07.005. PMID: 27544439.
52. Niu J, Ma J, Guan X, et al. Correlation Between Doppler Ultrasound Blood Flow Parameters and Angiogenesis and Proliferation Activity in Breast Cancer. Med Sci Monit. 2019;25:7035-41. https://doi.org/10.12659/MSM.914395. PMID: 31535669.
53. Janu E, Krikavova L, Little J, et al. Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions. BMC Med Imaging. 2020;20(1):66. https://doi.org/10.1186/s12880-020-00467-2. PMID: 32552678.
54. Zhu Y, Zhang D, Wang XN, et al. Diagnostic test of conventional ultrasonography combined with contrast-enhanced ultrasound in the subcategorization of suspicious Breast Imaging-Reporting and Data System (BI-RADS) 4 breast lesions. Transl Cancer Res. 2025;14(3):2066-77. https://doi.org/10.21037/tcr-2025-485. PMID: 40224988.
55. Liu S, Cai W, Luo Y, et al. CEUS Versus MRI in Evaluation of the Effect of Microwave Ablation of Breast Cancer. Ultrasound Med Biol 2022;48(4):617-25. https://doi.org/10.1016/j.ultrasmed-bio.2021.11.012. PMID: 35063290.
56. Bonfiglio R, Scimeca M, Toschi N, et al. Radiological, histological and chemical analysis of breast microcalcifications: diagnostic value and biological significance. J Mammary Gland Biol Neoplasia. 2018;23(1 2):89-99. https://doi.org/10.1007/s10911-018-9396-0. PMID: 29744755.
57. Moon JH, Koh SH, Park SY, et al. Comparison of the SRmax, SRave, and color map of strain-elastography in differentiating malignant from benign breast lesions. Acta Radiol. 2019;60(1):28-34. https://doi.org/10.1177/0284185118773510. PMID: 29726693.
58. Xiang LH, Yao MH, Xu G, et al. Diagnostic value of contrast-enhanced ultrasound and shear-wave elastography for breast lesions of sub-centimeter. Clin Hemorheol Microcirc. 2017;67(1):69-80. https://doi.org/10.3233/CH-170250. PMID: 28482623.
59. Zhu Y, Fan X, Yang D, et al. Contrast-Enhanced Ultrasound for Precise Sentinel Lymph Node Biopsy in Women with Early Breast Cancer: A Preliminary Study. Diagnostics (Basel). 2021;11(11):2104. https://doi.org/10.3390/diagnostics11112104. PMID: 34829452.
60. Li W, Zhao Y, Fei X, et al. Image Features and Diagnostic Value of Contrast-Enhanced Ultrasound for Ductal Carcinoma In Situ of the Breast: Preliminary Findings. Ultrason Imaging. 2025;47(2):59-67. https://doi.org/10.1177/01617346241292032. PMID: 39506270
61.
Review
For citations:
Chekina N.A., Afanasyev A.B., Abduraimov A.B., Andronov A.K. Radiation Research Methods with Contrast Enhancement in the Diagnosis of Breast Cancer: Literature Review. Journal of oncology: diagnostic radiology and radiotherapy. 2026;9(1):60-68. (In Russ.) https://doi.org/10.37174/2587-7593-2026-9-1-60-68
Views:
243
JATS XML
Email this article 