Over a period of three years, our hospital performed 1,414 CEM procedures on patients from 30 to 89 years old who presented with symptoms or suspicious findings on any breast imaging study, such as heterogeneously dense parenchyma, microcalcifications, nodules, distorsion, etcetera. It is important to remember that all diagnostic tests including breast imaging have a false-negative rate. For digital mammography, this varies from 20% to 30%, and is higher for women with dense breasts. Techniques that are able to show areas of neoangiogenesis like CEM or MRI are reported to have significantly lower rates.

From the total CEM number performed, 199 (14.07%) had negative CEM results, and 37 of them had microcalcifications or other manifestations in low energy imaging and underwent a biopsy, which had histopathologically positive results for breast cancer: 20 cases of infiltrating breast cancer, 16 cases of ductal carcinoma in situ and 1 case of invasive lobular cancer. The negative predictive value was 0.81, with 37 false negatives and 162 true negatives.