Purpose: To evaluate allergic reactions secondary to contrast-enhanced mammography (CEM).
Materials and Methods: HIPAA-compliant IRB approved retrospective review of all women who underwent CEM at our institution from January 2014 through December 2020 was performed. Medical records were reviewed for any adverse event occurring after intravenous injection of nonionic low-osmolality contrast media (Omnipaque [iohexol] 350, 1.5 mL/kg) for CEM, further selecting for symptoms of allergic reaction. For each adverse event, patient age, contrast dose, reaction description, reaction severity based on the ACR Manual on Contrast Media, and any treatment were recorded.
Results: In the study period, 5235 CEM exams were performed in 2419 unique patients (median age 59 years old). A total of 25 (0.48%) contrast reactions were documented in 23 (0.95%) patients, including 2 mild breakthrough reactions occurring in 2 patients after premedication with corticosteroids. Median dose administered for all exams was 101 mL (range 81-150 mL). Twenty-one (84%) of the 25 allergic reactions were mild, 4 (16%) were moderate, and none were severe. Antihistamines were administered to treat 14 (56%) reactions in 14 (61%) patients with prompt resolution of patients’ symptoms.
Conclusion: CEM is a safe breast imaging technique with low-allergic reaction rates (0.5%) that are mostly mild in severity.
Clinical Relevance Statement: Our study highlights the safety of administering iodinated contrast for contrast-enhanced mammography, with low adverse reaction rates of mild severity, comparable to those reported for computed tomography.
