Contrast-enhanced mammography-guided biopsy: why, when, and where we need it.

• The use of CEM-guided biopsy is spreading after initial experiences in a few pilot centers.• CEM-guided biopsy has the potential to ensure fast, low-cost, and effective tissue sampling of MRI-detected and CEM-detected lesions that do not have a corresponding finding at morphological imaging.• The need and utility of CEM-guided biopsy are warranted by the impending expansion of morpho-functional imaging towards breast cancer screening for women with extremely dense breasts.