ArticleInsights into imaging2026
Patient acceptance and experience with contrast-enhanced mammography in women with a personal history of breast cancer: findings from the COMBO trial.
Article in Insights into imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
objectivesTo evaluate patient acceptance, tolerability and experience with contrast-enhanced mammography (CEM) in women with a personal history of breast cancer undergoing routine post-surgical surveillance. MATERIALS AND
methodsThis prospective cohort study, conducted within the COMBO Trial, included consecutive women with a personal history of breast cancer undergoing CEM instead of digital mammography (DM) for routine surveillance from January 2023 to February 2025. Immediately after the examination, participants completed an anonymous 16-question questionnaire assessing discomfort, pain, exam duration, pre-examination reassurance, information received, anxiety, contrast injection, satisfaction and comparative experience with prior DM. Responses used Likert-type scales. Descriptive and non-parametric analyses were performed (p < 0.05 statistically significant).
resultsOf 969 eligible women, 936 (mean age 58.2 years, SD ± 10.2 years) completed the questionnaire. CEM was perceived as comparable to prior DM in terms of discomfort (631/936; 67.4%), pain (725/936; 77.4%), positioning (717/936; 76.6%) and duration (601/936; 64.3%). Overall satisfaction was high (900/936; 96.2%), and 932/936 (99.6%) of participants would recommend CEM. Although 433/936 (46.3%) of women reported moderate-to-high pre-examination anxiety, higher anxiety was significantly associated with greater perceived discomfort, pain, uncomfortable positioning, longer examination duration, lower reassurance, lower comfort during contrast medium administration, and lower overall satisfaction (all p < 0.001).
conclusionsIn this large cohort of breast cancer survivors, CEM demonstrated high acceptance, satisfaction and tolerability in post-surgical follow-up. Although pre-examination anxiety negatively influenced examination experience, it did not reduce patients' willingness to undergo CEM, supporting its integration into personalised post-treatment breast cancer surveillance. KEY POINTS: Question Evidence on patient acceptance and tolerability of CEM for routine post-surgical surveillance in women with previous breast cancer is limited. Findings In 936 breast cancer survivors, CEM showed high satisfaction and tolerability, while pre-examination anxiety was associated with a less favourable experience. Critical Relevance Statement High patient acceptance supports CEM as a feasible surveillance option after breast cancer treatment, while the association between anxiety and poorer experience highlights the radiologist's role in pre-examination communication and reassurance.
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