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Interval Cancers after Negative Screening Contrast-enhanced Mammography.
Tali Amir1, Carol H Lee1, Sarah Eskreis-Winkler1
1Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065.
Radiology. Imaging Cancer
|May 1, 2026
Summary
The interval cancer rate after contrast-enhanced mammography (CEM) screening was 2.29 per 1000 exams. Most interval cancers were occult on prior CEM, with invasive types more common with marked background parenchymal enhancement.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Screening mammography is crucial for early breast cancer detection.
- Contrast-enhanced mammography (CEM) offers improved visualization of breast lesions.
- Understanding interval cancers (ICs) is vital for refining screening protocols.
Purpose of the Study:
- To calculate the interval cancer rate (ICR) following negative screening CEM.
- To compare characteristics of ICs with CEM screen-detected cancers.
- To identify factors associated with interval cancers after CEM screening.
Main Methods:
- Retrospective analysis of screening CEM examinations (January 2015 - December 2021).
- Identification of interval cancers diagnosed within one year of negative CEM.
- Radiologist review of prior CEMs to classify ICs (missed, misinterpreted, occult).
Main Results:
- Overall ICR was 2.29 per 1000 examinations; 13% of all diagnosed cancers were ICs.
- Invasive ICs were more frequent with moderate/marked background parenchymal enhancement (75% vs. 30%).
- Most ICs (71%) were occult on prior screening CEM examinations.
Conclusions:
- The ICR after CEM screening is 2.29 per 1000 examinations.
- A significant proportion of interval cancers are occult on prior CEM.
- Background parenchymal enhancement is associated with invasive interval cancers.
