{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:50:50Z","timestamp":1792151450353,"version":"4.4.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      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 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 statistically significant).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 969 eligible women, 936 (mean age 58.2 years, SD\u2009\u00b1\u200910.2 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\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2019 willingness to undergo CEM, supporting its integration into personalised post-treatment breast cancer surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      Evidence on patient acceptance and tolerability of CEM for routine post-surgical surveillance in women with previous breast cancer is limited.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      In 936 breast cancer survivors, CEM showed high satisfaction and tolerability, while pre-examination anxiety was associated with a less favourable experience.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Critical Relevance Statement<\/jats:italic>\n                      <\/jats:bold>\n                      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\u2019s role in pre-examination communication and reassurance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-026-02434-x","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:08:58Z","timestamp":1792148938000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient acceptance and experience with contrast-enhanced mammography in women with a personal history of breast cancer: findings from the COMBO trial"],"prefix":"10.1186","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2568-2768","authenticated-orcid":false,"given":"Giulia","family":"Vatteroni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Levi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Filippini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubina Manuela","family":"Trimboli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bernardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"2434_CR1","doi-asserted-by":"publisher","first-page":"6264","DOI":"10.1007\/s00330-024-10684-w","volume":"34","author":"J Camps-Herrero","year":"2024","unstructured":"Camps-Herrero J, Pijnappel R, Balleyguier C (2024) MR-contrast enhanced mammography (CEM) for follow-up of breast cancer patients: a \u201cpros and cons\u201d debate. 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The remaining authors declare\u00a0that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"262"}}