Objective: The imaging principle of contrast-enhanced digital mammography (CEDM) is based on the same principle as magnetic resonance imaging (MR), i.e., the representation of neovascularization. The aim of this work is to compare the sensitivity of CEDM in the detection of malignant lesions in the breast with MR and to determine the sensitivity and specificity of the mentioned methods. Patients and methods: Fifty-six subjects were included (55 women and 1 man; median age 63.51 years; range 40-88 years) in whom, based on findings on digital mammography, the suspicion of a malignant process on the breast was raised. All subjects underwent breast ultrasound, MR, CEDM, and a biopsy of the suspicious lesion was performed. An indication for CEDM is a vague or suspicious shadow, distortion, asymmetry, or a cluster of pathological microcalcifications on digital mammography. Results: In 13 (23.21%) subjects there was contrast enhancement of lesions on both CEDM and MR. Of the total number of subjects, 15 (26.78%) were diagnosed with a malignant lesion, and in 17,85% contrast enhancement occurred only during the CEDM procedure, of which 7 lesions were malignant (invasive carcinoma and ductal carcinoma in situ with an invasive component). The specificity and sensitivity of MR is 97.1% and 85.7%, respectively (ROC-AUC = 0.914, PPV 92.3%, NPV 94.3%). The specificity and sensitivity of CEDM is 94.1% and 100%, respectively (ROC-AUC = 0.971, PPV 91.3%, NPV 100%). Conclusion: CEDM is a procedure equivalent to MR in the detection of suspicious lesions in the breast and may replace MR in assessing the extent of disease when MR is unavailable or contraindicated. CEDM is a complementary diagnostic method to MR when MR cannot be performed and shows a good correlation in the detection of malignant lesions in the breast.