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How many cancers do you see on this mammogram? The new 'monster catcher' mammogram in North Florida

CEM stands for Contrast-Enhanced Mammography. It's coming to our First Coast for the first time to help women at above-average risk of breast cancer.

AMELIA, Fla. — "Breast cancer is sneaky. It likes to hide," according to radiologist Dr. Gaelyn Scuderi.

Dr. Scuderi is a Diagnostic Radiologist and Director of Imaging at Ackerman Cancer Center in Amelia Island. She is "thrilled" that, after working towards this goal for three years, she can finally announce CEM will be available on the First Coast for the first time.

CEM is short for Contrast-Enhanced Mammography. Dr. Scuderi explained it's geared to help women with a higher than average risk of breast cancer. That could be you, if you have a first or second-generation relative with breast cancer, like a grandmother or a sister on either your paternal or maternal side.

Faye Laughinghouse, a cheerful breast cancer patient at Ackerman, was told by her doctor she has dense breasts, making it harder to pick up tiny cancers on mammography or even by self-exam.

Credit: Screening mammogram showing one lesion - Ackerman Cancer Center

She had a 2-D and a 3-D screening mammogram and a small bright white spot showed up.  That told doctors she might have breast cancer. Then she had CEM, a diagnostic mammogram done in about ten minutes with a contrast IV. 

The CEM picked up another white spot.  

"There's a second mass right next to the first one. It's smaller, about two millimeters," Scuderi said.

Turns out they are both cancer.

Credit: Ackerman Cancer Center -CEM

Dr. Scuderi says perhaps that second cancer, which didn't show up in the traditional mammogram, would be found during surgery to remove the first lump. But now with the CEM image, it's for certain the doctors will be able to target it and work to remove it.

But at two millimeters, what is so monumentally important about that tiny lesion?

"That could have been her recurrence down the line," Scuderi said.

In other words, the sneaky monster of breast cancer could have been lying in wait to attack, even though the first breast cancer surgery would appear to be a success.

Dr. Scuderi believes the CEM gives patients peace of mind. For Faye, it "enabled her to have a surgical cure without worry there might be other areas of cancer hiding." 

“Every patient is different, and with these technologies, we now have another set of tools to aid in the diagnosis of breast cancer,” Scuderi said.  

However, not everyone is a candidate for CEM, according to Scuderi. She suggests speaking with your doctors to see if CEM is a good idea for you or not. 

Another option, traditionally, for women at higher risk is breast MRI.  Dr. Scuderi says CEM is typically less expensive, sometimes $250 compared with $1,000 for an MRI.  And, she says, most insurance companies pick up most of the CEM cost when they bill patients for diagnostic mammograms.

The important point is all mammograms of any type can save lives. A traditional mammogram, still done at local hospitals, can find pre-cancers as tiny as grains of sand. So don't skip your mammogram.

Credit: Faye Laughinghouse

"I'm just blessed I'm in the right place at the right time," Laughinghouse said. She says she's grateful for Dr. Scuderi and the entire staff at Ackerman Cancer Center on Amelia.

Now she's optimistic she can put cancer behind her and enjoy her life with the people she loves.

Here are some more details from Ackerman Cancer Center on the CEM:

The addition of CEM helps deliver high sensitivity for a more accurate breast cancer diagnosis and allows for immediate additional testing performed on the same system, in the same room and often with the same staff. CEM is just like a normal mammogram except it uses a contrast medium, which is a substance that is injected into the bloodstream and shows up on an x-ray. The contrast medium collects in tissues with robust blood flow, especially cancerous tissues, enabling the radiology team to study that area in more detail. CEM is performed simultaneously with a 2D mammogram. 3D mammography can also be performed at the same visit.

To reach Ackerman Cancer Center, call 904-880-5522.


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