Role of Contrast Enhanced Spectral Mammography to Predict Upgrade Rates of Biopsy Proven Atypical Ductal Hyperplasia

Inclusion Criteria: * Age, Minimum 30 years. CESM is an imaging exam that uses radiation and is not typically employed in women younger than age 30 due to potentially negative biologic effects on glandular breast tissue. * Participants who had a percutaneous breast biopsy (to include stereotactic, tomosynthesis, or ultrasound guided) that revealed ADH * Participants will be undergoing surgical excision to remove the ADH. * Participants must have normal organ and marrow function as defined by a GFR ≥60 mL/min/1.73 m2 to be performed per clinical protocol * Patients ≥65 years without underlying renal insufficiency get GFR tested within 6 months of the exam. * Patients \< 65 years without underlying renal insufficiency do not require an GFR calculation) * Patients ≥65 years with known underlying renal insufficiency get GFR tested within 1 month of the exam. * Patients \< 65 years with known renal insufficiency get GFR tested within 1 month of the exam. * Because of the potential teratogenic effects of radiation, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, until the CESM is performed. Should a woman become pregnant or suspect she is pregnant, she should inform the study team prior to getting the CESM. * Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: * Participants with a core biopsy diagnosis of atypia with ass…