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So you need a contrast mammogram. Some things you might like to know...

Download this patient information page as a PDFWhat is a contrast mammogram?

Contrast mammography is a relatively new technique. That said, it is a variation on the technique of a mammogram, where the mammogram is performed after an injection of x-ray dye, also known as a contrast agent.

After answering some questions to ensure you are able to be given x-ray contrast, a nurse or radiographer will insert a cannula (small plastic tube) into a vein in your arm. Imaging typically commences 2 minutes after the injection of contrast. You will be asked to stand up and you will have both breasts imaged within the next 8 minutes.

Two mammograms are obtained of both breasts in each direction with compression. One mammogram is obtained at low energy and the second at higher energy. Special techniques are then used to show only the breast tissue that has taken up the dye. It is very important that you do not move whilst the images are being obtained to ensure the images are of a high quality.

Contrast mammograms are extremely well tolerated procedures and can be used to solve issues raised with traditional mammography and ultrasound, to evaluate the extent of disease in an already documented cancer, and to provide greater diagnostic confidence for women with dense breasts, with symptoms or who are at higher risk.

The results are usually provided to your referring doctor within 24 hours. Please let us know what you and your doctor have arranged with regards to follow up appointments so we can ensure the report is available for you in a timely fasion.

What is contrast / x-ray dye?

The contrast (dye) used is injectable iodine. This type of contrast agent is the same as that used for CT scans. When the injection is happening, it is quite common to feel warm and flushed. Sometimes people get a hot feeling in the pelvis and they are concerned they will wet their pants. That never happens. It is just a strange feeling. You may also notice a funny metallic taste in your mouth. Don’t be alarmed if you experience these sensations. On occasion, people can feel nauseated for a short period of time, although with newer contrast agents this happens infrequently.

Contrast agent is removed from your body in your urine. Therefore, it is important to drink plenty of fluids after the test.


What are the risks of a contrast mammogram?

Risks can be separated into those associated with the mammogram itself and the risks related to an injection of x-ray dye.

The risks for mammography relate to the use of radiation. You can see more information on these risks on our mammography page.

The risks in relation to contrast are complications from the dye leaking out of the vein and the risk of an allergic reaction to the dye. The cannula is placed into the vein, however infrequently the cannula may pierce the vein wall and the dye is then injected into the tissue outside the vein. If you experience pain upon injection please tell the radiographer with you at the time. If this occurs the contrast can cause pain and swelling to the area. This is usually treated with ice and compression.

If you have kidney disease, diabetes, or both, the contrast can make your kidney function worse. It will usually return to normal. This will be discussed with you prior to injection if relevant. If you are diabetic and take metformin or medications containing metformin, you will need a recent blood test result to check your kidney function. You may need to stop metformin and wait 48 hours after the contrast injection before recommencing this medication, depending on individual circumstances. This will be discussed with you prior to your mammogram.

Allergic reactions are infrequent but they do occur. At San Radiology, we are always ready to manage these with appropriate treatment if required. Typically an allergic reaction will occur within minutes of the injection, however delayed reactions have been reported. Serious reactions rarely occur more than one hour after an injection. Minor allergic reactions may not require treatment or may be treated with antihistamines to decrease a raised, red itchy rash. These milder forms of allergic reaction occur in approximately 1 in every 1,000 patients. Moderate reactions include vomiting; a generalised rash; or face, mouth or throat swelling with difficulty breathing or swallowing, and these can also occur in about 1 in 1,000 people. These reactions will require treatment. Severe reactions including death are rare, estimated to occur in 1 in 100,000 people. Severe reactions require emergency medical treatment with admission to hospital for more prolonged observation. We are well equipped to care for patients in the rare occasion this does occur.


What preparation is required for a contrast mammogram?

For women who are still having periods, it is best to book your contrast mammogram during the week after your period starts when your breasts are the least tender, providing the examination is not considered urgent.

Please do not wear deodorant or talcum powder on the day of the examination, as these can contain materials visible on the contrast mammogram which can complicate image interpretation. Wearing a shirt with a skirt, shorts or trousers is usually more comfortable for you, as you will then only need to remove your shirt and bra.

If you have had prior breast imaging elsewhere (mammography, ultrasound or MRI of the breasts), please bring these imaging studies and reports with you.


Further Information

Please contact San Radiology if you have any questions or to make an appointment.

 

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