Patient acceptance and experience with contrast-enhanced mammography in women with a personal history of breast cancer: findings from the COMBO trial
Abstract
Objectives: To 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 methods: This 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).
Results: Of 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).
Conclusions: In 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.
Related
- Contrast‑enhanced ultrasound-guided sclerotherapy of vascular malformations in the head and neck: Initial clinical experience in a paediatric case series
- OP–194 Experience or perception? Factors determining RSV immunization acceptance among caregivers
- iSL-YOLOv11: global–local attention enhanced small lesion detection in mammography images
- Music-based immersive technology experience and adolescents’ perceived alleviation of anxiety symptoms: cross-sectional evidence on the mediating roles of cognitive restructuring, self-acceptance, and self-efficacy
- Contrast-enhanced ultrasound-assisted catheter drainage for paravertebral tuberculous abscesses: a retrospective study of procedural safety
BibTeX
@article{vatteroni2026patient,
title = {{Patient acceptance and experience with contrast-enhanced mammography in women with a personal history of breast cancer: findings from the COMBO trial}},
author = {Giulia Vatteroni and Riccardo Levi and Marco Filippini and Martina Costa and Rubina Manuela Trimboli and Daniela Bernardi},
journal = {Insights into imaging},
year = {2026},
month = oct,
doi = {10.1186/s13244-026-02434-x},
url = {https://europepmc.org/article/PMC/PMC13675458},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient acceptance and experience with contrast-enhanced mammography in women with a personal history of breast cancer: findings from the COMBO trial
AU - Giulia Vatteroni
AU - Riccardo Levi
AU - Marco Filippini
AU - Martina Costa
AU - Rubina Manuela Trimboli
AU - Daniela Bernardi
PY - 2026
DA - 2026/10/16
JO - Insights into imaging
DO - 10.1186/s13244-026-02434-x
UR - https://europepmc.org/article/PMC/PMC13675458
AB - Objectives: To 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 methods: This 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). Results: Of 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). Conclusions: In 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.
SN - 1869-4101
ER -