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

Technology | Focused Ultrasound Therapy | June 19, 2018
EDAP TMS SA has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Focal One device for...
Clinical Trial Testing Topical Gel to Reduce Breast Density
News | Breast Density | June 19, 2018
Women with dense breast tissue soon might be adding a new product to their skincare routine to help them fight breast...
Epsilon Imaging Demonstrates Strain Imaging Integration for Echo Programs at ASE 2018
News | Cardiovascular Ultrasound | June 19, 2018
Clinical practice, along with guidelines and research, have shown that speckle tracking strain imaging can improve...
FDA Clears Bay Labs' EchoMD AutoEF Software for AI Echo Analysis
Technology | Cardiovascular Ultrasound | June 19, 2018
Cardiovascular imaging artificial intelligence (AI) company Bay Labs announced its EchoMD AutoEF software received 510(...
California Women In Favor of Extending State's Breast Density Inform Law
News | Breast Density | June 15, 2018
A recent survey of California women found that 95 percent of respondents want the state’s breast density inform law to...
Hitachi Medical Systems Europe Named Imaging Supplier for London Prostate Cancer Program
News | Prostate Cancer | June 14, 2018
Hitachi Medical Systems Europe has been awarded the contract to supply six ultrasound systems as part of the RAPID...
Women More Likely to Use Other Preventive Health Services Following Mammography
News | Mammography | June 13, 2018
Medicare beneficiaries who undergo breast cancer screening with mammography are more likely than unscreened women to...
How AI and Deep Learning Will Enable Cancer Diagnosis Via Ultrasound

The red outline shows the manually segmented boundary of a carcinoma, while the deep learning-predicted boundaries are shown in blue, green and cyan. Copyright 2018 Kumar et al. under Creative Commons Attribution License.

News | Ultrasound Imaging | June 12, 2018 | Tony Kontzer
June 12, 2018 — Viksit Kumar didn’t know his mother had...
Breast imaging technologies have seen a rapid evolution.

Breast imaging technologies have seen a rapid evolution.

Feature | Women's Health | June 05, 2018 | By Jeff Zagoudis
Breast imaging technologies have evolved rapidly in the last two decades to help physicians detect breast cancers at
Olympus and Hitachi Healthcare Americas Introduce Arietta 850
News | Ultrasound Imaging | June 04, 2018
Olympus, a global technology leader in designing and delivering innovative solutions for medical and surgical procedu
Overlay Init