Contrast‐enhanced spectral mammography (<scp>CESM</scp>) and contrast enhanced <scp>MRI</scp> (<scp>CEMRI</scp>): Patient preferences and tolerance

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Contrast‐enhanced spectral mammography (<jats:styled-content style="fixed-case">CESM</jats:styled-content>) may have similar diagnostic performance to Contrast‐enhanced MRI (<jats:styled-content style="fixed-case">CEMRI</jats:styled-content>) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of <jats:styled-content style="fixed-case">CESM</jats:styled-content> against <jats:styled-content style="fixed-case">CEMRI</jats:styled-content> during preoperative breast cancer staging.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Forty‐nine participants who underwent both <jats:styled-content style="fixed-case">CESM</jats:styled-content> and <jats:styled-content style="fixed-case">CEMRI</jats:styled-content>, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (<jats:styled-content style="fixed-case">IV</jats:styled-content>) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a <jats:styled-content style="fixed-case">W</jats:styled-content>ilcoxon sign‐rank test and chi‐squared test. Qualitative data are reported descriptively.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A significantly higher overall preference towards <jats:styled-content style="fixed-case">CESM</jats:styled-content> was demonstrated (<jats:italic>n</jats:italic> = 49, <jats:italic>P</jats:italic> < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during <jats:styled-content style="fixed-case">CESM</jats:styled-content> compared with <jats:styled-content style="fixed-case">CEMRI</jats:styled-content> (<jats:italic>n</jats:italic> = 36, <jats:italic>P</jats:italic> = 0.009). A significantly higher rate of comfort was reported during <jats:styled-content style="fixed-case">CEMRI</jats:styled-content> for measures of breast compression (<jats:italic>n</jats:italic> = 49, <jats:italic>P</jats:italic> = 0.001) and the sensation of <jats:styled-content style="fixed-case">IV</jats:styled-content> contrast injection (<jats:italic>n</jats:italic> = 49, <jats:italic>P</jats:italic> = 0.003).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our data suggest that overall, patients prefer the experience of <jats:styled-content style="fixed-case">CESM</jats:styled-content> to <jats:styled-content style="fixed-case">CEMRI</jats:styled-content>, adding support for the role of <jats:styled-content style="fixed-case">CESM</jats:styled-content> as a possible alternative to <jats:styled-content style="fixed-case">CEMRI</jats:styled-content> for breast cancer staging.</jats:p></jats:sec>