Savaridas SL, et al. – Here, the clinicians intend to compare background parenchymal enhancement (BPE) on contrast–enhanced (CE) spectral mammography (CESM) with CE magnetic resonance imaging (MRI), and assess how these relate to hormonal status, mammographic breast density (MBD) and MRI fibroglandular tissue volume (FGTV). Evidence showed that contrast–enhanced spectral mammography background parenchymal enhancement is associated with mammographic breast density, fibroglandular tissue volume, and CEMRI BPE, has better inter–reader reliability than CEMRI, and is not influenced by the menstrual cycle. Grading the degree of BPE on CESM could be a useful addition to breast cancer risk assessment tools.