Contrast Enhanced Spectral Mammography in Predicting Breast Cancer in Participants with Atypical Ductal Hyperplasia

Inclusion Criteria

• CESM is an imaging exam that uses radiation and is not typically employed in women younger than age 30 due to potentially negative biologic effects on glandular breast tissue.
• Participants who had a percutaneous breast biopsy (to include stereotactic, tomosynthesis, or ultrasound guided) that revealed ADH.
• Participants will be undergoing surgical excision to remove the ADH.
• Participants must have normal organ and marrow function as defined by a glomerular filtration rate (GFR) >= 60 mL/min/1.73 m^2 to be performed per clinical protocol.
• CLINICAL PROCOTOL USED AS REFERENCE FOR THIS STUDY:
• Patients >= 65 years without underlying renal insufficiency get GFR tested within 6 months of the exam.
• Patients < 65 years without underlying renal insufficiency do not require an GFR calculation.
• Patients >= 65 years with known underlying renal insufficiency get GFR tested within 1 month of the exam.
• Patients < 65 years with known renal insufficiency get GFR tested within 1 month of the exam.
• Because of the potential teratogenic effects of radiation, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, until the CESM is performed. Should a woman become pregnant or suspect she is pregnant, she should inform the study team prior to getting the CESM.
• Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

• Participants with a core biopsy diagnosis of atypia with associated malignancy (in the same quadrant) will be excluded.
• Participant had a breast magnetic resonance imaging (MRI) that was performed after the diagnosis of ADH but before surgical excision.
• Participants who have a known allergy to contrast media.
• Participants who have a known severe allergic response to one or more allergens, as defined by anaphylaxis.
• Participants with persistent asthma as defined by the National Heart, Lung, and Blood Institute.
• Participants with renal insufficiency or failure, as determined by a point of care renal function blood test.
• Participants who are breastfeeding are excluded because there is an unknown but potential risk for adverse events in nursing infants secondary to contrast administration in the mother.
• Participants with the following underlying medical conditions: multiple myeloma, myasthenia gravis, dysproteinemias, severe cardiac disease, aortic stenosis, primary pulmonary hypertension, cardiac arrhythmia, or severe cardiomyopathy. These underlying medical conditions may make the participant more likely to develop a contrast reaction. This is based on the American College of Radiology (ACR) contrast manual version 10.3 and hospital policy.
• Participants with thyroid carcinoma or thyroid disease for whom systemic radioactive iodine therapy is part of planned diagnostic work-up or treatment within 2 months following the contrast mammogram study.
• Participants with a concurrent active illness including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, thyroid storm.
• Pregnant women are excluded from this study because CESM uses radiation with the potential for teratogenic or abortifacient effects. This will be defined by a urine pregnancy test prior to the CESM study.