OU Health Performs First Contrast-Enhanced Mammography in Oklahoma

Women with dense breast tissue now have access to new and advanced imaging technology that helps doctors zero in on potential abnormalities using contrast dye in conjunction with a standard mammogram.

The technology, called contrast-enhanced mammography (CEM), is only available in Oklahoma at OU Health and is currently offered at the breast imaging clinic located in the OU Health Physicians Building near downtown Oklahoma City. CEM provides improved and non-invasive diagnostic accuracy compared to a standard mammogram.

Approximately 50% of women who have a mammogram have dense breast tissue, which makes the images more difficult to interpret. Dense breast tissue refers to the appearance of how breast tissue looks on a mammogram. Breast tissue is composed of milk glands, milk ducts, glandular tissue and fatty tissue. Glandular tissue is what is known as dense breast tissue and fatty tissue is considered nondense breast tissue. Cancer and dense breast tissue appear white in an X-ray, making it harder to distinguish between the two and may increase the likelihood that cancer may go undetected. CEM is also beneficial for patients who have had inconclusive results from a mammogram, are at high-risk for cancer and those who cannot have an MRI.

CEM involves patients receiving an iodinated contrast dye injection through an IV prior to receiving a standard mammogram. A standard mammogram looks at the structure of the breast and can identify masses, calcification, or areas that appear distorted. With CEM, those things can still be identified, but in addition, the blood flow to the breast can be assessed. Cancers recruit blood supply and this is one of the early identifiers in cancer — abnormal blood flow supply.

Christina Earley, of Oklahoma City, was the first OU Health patient to receive CEM. Earley, a 41-year-old mother of three, is considered a high-risk patient for breast-cancer. A previous mammogram indicated potential abnormalities that required follow-up. Earley had an ultrasound and another 3D mammogram, but the results were not conclusive due to her dense breast tissue. Natalie Stratemeier, M.D., recommended Earley have either a biopsy of the area, or CEM.

“Dr. Stratemeier explained that the contrast would flow through my breast and if there was any cyst or tumor that needed to be biopsied, the contrast wouldn’t flow through it. That way they would know if it was dense tissue they were looking at, or something that needed further investigation,” said Earley. “Dr. Stratemeier was there the whole time and she said that everything looked okay. She checked it with another physician one more time and confirmed it was clear and I was able to leave with all of my worries alleviated. I didn’t need further testing and I could go about planning my son’s 7^th birthday party without nervously waiting for the test results.”

CEM was first approved by the FDA in 2011 for diagnostic mammography. Many studies using CEM have demonstrated increased cancer detection in women with dense breast tissue compared to a standard mammogram. CEM is less costly and faster than an MRI, with results being delivered in real-time. As CEM is a software package, it can be implemented at current mammography sites making it fast to install and offering increased access to patients. The new CEM software at OU Health was purchased as the result of a generous donation from Jane Harlow and the Friends of the OU Breast Institute.

Stratemeier said, “This is a fantastic opportunity that Oklahomans have. This is an additional service we can offer to patients who are high-risk or have dense breast tissue and cannot get an MRI. CEM offers similar result to an MRI without the expense, time and discomfort. It also can potentially avoid uncomfortable and expensive biopsies and gives real-time results. It can detect possible cancers before there’s even a mass as it assesses the blood flow. We are so grateful to the donors for the funding which allowed us to add CEM to our services.”

To schedule CEM, patients will need a request from their healthcare provider.