News | December 08, 2009

Annual Screening with Breast Ultrasound or MRI Found Beneficial

December 8, 2009 - Annual screening with ultrasound in addition to mammography significantly improves the detection of early breast cancer, reported Wendie A. Berg, M.D., Ph.D., breast imaging specialist at American Radiology Services, Johns Hopkins – Green Spring Station in Lutherville, Md.

Dr. Berg, the lead researcher of a large-scale clinical trial, presented results at RSNA 2009, providing the first strong evidence of the benefit of annual screening ultrasound for women with dense breasts who are at elevated risk for breast cancer. In addition, the study confirmed that MRI is highly sensitive in depicting early breast cancer.

"[S]ignificantly more early breast cancer can be found when MRI is performed, even after combined screening with both ultrasound and mammography," added Dr. Berg. "However, both ultrasound and MRI increase the risk of false-positive findings.”

The report noted that women who are at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, women below age 50 are more likely to have dense breast tissue, which can limit the effectiveness of mammography as a screening tool.

Multicenter trials have shown that MRI enables radiologists to accurately identify tumors missed by mammography and ultrasound. The American Cancer Society recommends that some groups of women with a high risk of developing breast cancer should be screened with MRI in addition to their yearly mammogram beginning at age 30. However, MRI is not for everyone.

“Because MRI is a very expensive test and requires intravenous contrast, it is something we only recommend for screening the approximately two percent of women who are known or likely carriers of BRCA-1 or BRCA-2 gene mutations or have other unusual circumstances that put them at very high risk for breast cancer,” Dr. Berg said.

“There are another 10 to 15 percent of women who are at some increased risk because of personal history of breast cancer, family history of breast cancer and/or dense breast tissue,” she added. “For many of these women, MRI is not currently justified, but annual ultrasound would be appropriate in addition to mammography.”

The researchers studied 612 women, mean age 55 years, at elevated risk of breast cancer enrolled at 14 sites in the American College of Radiology Imaging Network (ACRIN) 6666 trial funded by the Avon Foundation and the National Cancer Institute. Women underwent baseline screening mammography and ultrasound with follow-up exams at 12 and 24 months and then a single, contrast-enhanced MRI at 24 months.

Sixteen women were diagnosed with breast cancer. Twelve of the cancers were invasive, and four were ductal carcinoma in situ (DCIS). Over the course of the study, 50 to 56 percent of cancers were shown on mammography. Adding ultrasound allowed detection of 70 to 94 percent of cancers. Adding MRI allowed for detection of additional cancers at their earliest stage.

The study also found that supplemental screening with ultrasound or MRI significantly increased the risk of false-positive findings, leading to unnecessary biopsies in some women.

“It is important that women are advised of the increased potential of undergoing an unnecessary biopsy as a result of screening with ultrasound or MRI,” Dr. Berg indicated, “but we hope this study motivates women and their doctors to learn more about their risk factors and to consider supplemental screening in addition to mammography where indicated.”

Coauthors are Zheng Zhang, Ph.D., Jean B. Cormack, Ph.D., Roberta A. Jong, M.D., Richard G. Barr, M.D., Ph.D., Daniel E. Lehrer, M.D., and other ACRIN 6666 investigators.

For more information: www.rsna.org

Related Content

Hologic Opens Learning and Experience Centre in Zaventem, Belgium
News | Women's Health | March 21, 2019
Hologic Inc. opened its first Learning and Experience Centre in Zaventem, Belgium. The state-of-the-art facility...
Fujifilm Launches Three New Software Tools for Aspire Cristalle Digital Mammography System
Technology | Mammography | March 15, 2019
Fujifilm Medical Systems USA announced it has fulfilled all U.S. Food and Drug Administration (FDA) regulatory...
Bay Labs Announces New Data on EchoGPS, AutoEF AI Software at ACC.19
News | Cardiovascular Ultrasound | March 15, 2019
Artificial intelligence (AI) company Bay Labs announced the presentation of two studies assessing performance of the...
Esaote Introduces MyLab X8 Ultrasound Platform
News | Ultrasound Imaging | March 13, 2019
Esaote announced the launch of MyLab X8, a high-performance, versatile ultrasound platform to support hospitals and...
CT, Mammograms Offer Clues to Preventing Heart Problems After Cancer Treatment
News | Cardio-oncology | March 13, 2019
An imaging procedure commonly performed before starting cancer treatment can provide valuable clues about a patient's...
Ultrasound Societies Urge FDA to Remove "Black Box" on Ultrasound Contrast Agents
News | Ultrasound Imaging | March 07, 2019
National and international ultrasound societies are urging the U.S. Food and Drug Administration to remove the “black...
South Dakota's Density Inform Bill Signed Into Law
News | Breast Density | March 06, 2019
With the passage of HB1124, South Dakota becomes the 37th state with breast density inform legislation. The law, which...
iCAD Partnering With Karolinska Instituet Researchers on AI-based Breast Cancer Risk Prediction
News | Oncology Diagnostics | March 04, 2019
iCAD announced their intent to enter an exclusive relationship with two leading researchers at The Karolinska...
Canon Medical Systems introduces 33 MHz Ultra-High Frequency Ultrasound Transducer
News | Ultrasound Imaging | March 01, 2019
March 1, 2019 — Expanding its advanced, high-performing Aplio i-series...
ACR Helping Radiologists Avoid Massive Ultrasound Reimbursement Cuts
News | Ultrasound Imaging | February 27, 2019
The American College of Radiology (ACR) urges radiologists and allied professionals to help the college ward off $112...