Mediolateral oblique (MLO) view of CESM subtraction images in a 61-year-old woman with mastodynia and dubious ultrasound finding of the right breast (BI RADS 4a). The subtraction image shows a mass enhancement in the upper outer quadrant of right breast (white arrow), measuring less than 10 mm. The enhancement is mild, homogeneous, regular, and purified (enhancement score 0). The biopsy confirms a benign lesion (fibrocystic mastopathy).