(a, c) Mediolateral oblique (MLO) and craniocaudal (CC) views of digital mammography depicting two lesions of the right breast categorized as breast imaging-reporting and data system (BIRADS) 3; (b, d) MLO and CC views of contrast-enhanced spectral mammography (CESM): Type −1 enhancement of the lesion, MPS = 3 + (−)1= 2 < 4. On ultrasound, two cysts were depicted; (e, g) MLO and CC digital mammography views of the left breast depicting a small BIRADS 4 lesion with microcalcifications (small arrows) and a bigger BIRADS 4 lesion (long arrows); (f, h) MLO and CC views of CESM Type 2 enhancement (long arrows) and Type 1 enhancement (small arrows). MPS1 for the small lesion (small arrows): 4 + 1 = 5 and MPS2 for the lesion (long arrows) = 6 > 4. Histopathology result (left breast): two foci of ductal carcinoma grades III and II, respectively.