Fig. 2

A 35-year-old female that had a palpable left breast lump. a Bilateral digital mammogram craino-caudal views that showed right breast upper outer and central regional asymmetrical density and associate upper outer segmental clustered pleomorphic microcalcifications malignant looking masses that extent beyond the confine of the asymmetrical density. b CEM of both breasts craino-caudal view that showed heterogeneous enhancement of the right breast asymmetrical density, while the area involved with the clustered microcalcifications showed no contrast uptake. The case was proved to be invasive ductal carcinoma and ductal carcinoma in situ. CEM images provided information about the actual extent of the disease in the form of a vascular enhancing invasive component and the distribution of the non-enhancing component of calcifications. This can significantly change the management from breast-conservative surgery to mastectomy