Contrast Enhanced Mammography or Breast Magnetic Resonance: Which Choice for Optimal Diagnostic Performance?

Inclusion Criteria: * Age: Women aged 18 years and older. * Indication for Advanced Imaging: Patients referred for Contrast-Enhanced Mammography (CEM) or Breast MRI due to suspicious findings or high-risk factors for breast cancer. * Dense Breast Tissue or Inconclusive Findings: Patients with dense breast tissue or inconclusive results from standard mammography. Informed Consent: Ability to provide written informed consent for participation in the study. \- Presence of Breast Tissue: Female or transgender women who have breast tissue suitable for imaging. Exclusion Criteria: * Contraindications to MRI: Patients with contraindications to Breast MRI (e.g., implanted pacemakers, severe claustrophobia, or metallic implants that cannot be removed). * Contraindications to Contrast Agents: Patients who have allergies or contraindications to iodinated contrast agents used in CEM. Severe Renal Impairment: Patients with severe renal impairment (eGFR \< 30 mL/min/1.73 m²), as they may not safely undergo contrast-enhanced imaging. * Pregnancy or Breastfeeding: Women who are pregnant or breastfeeding, as the use of contrast agents may pose risks to the fetus or infant. * Already Confirmed Primary Tumor: Patients with a confirmed primary breast malignancy or another primary tumor site (e.g., gastrointestinal, lung) that has already been diagnosed. * Other Medical Conditions: Patients with serious medical conditions that may interfere with participation in the study or may affect the safety of the imaging procedures.