Breast Cancer Detection: Ultrasound EQUAL to Mammography!

Breast cancer is one of the most prolific type of ailment that has plagued women for many years. In order to fight the disease, experts agree that focusing more on ultrasound can help detect and fight the illness while still in its early stage.

In a study published by the Journal of the National Cancer Institute, researchers concluded that ultrasound and mammography appear equally likely to detect breast cancer. Breast cancer cases are increasing worldwide; more than 1.6 million new cases of the disease were diagnosed in 2010, resulting in more than 425,000 deaths. Furthermore, an estimated 2.1 million new diagnoses of breast cancer are expected by 2030. Mammography is proven effective in detecting breast cancer in developed countries; however, it is not commonly available in less developed nations, and alternative methods, such as ultrasound, need to be investigated.

Researchers at Magee-Womens Hospital, in Pittsburgh, Pennsylvania, recruited 2809 women across 20 sites in the United States, Canada, and Argentina to the American College of Radiology Imaging Network protocol 6666 breast cancer screening study. The objective was to determine the effectiveness of ultrasound in detecting breast cancer.

Of the participants, 2662 completed 3 annual breast screenings by US and film-screen or digital mammography, then underwent a biopsy or a 12-month follow-up.

Study results show the number of ultrasound screens needed to detect breast cancer was comparable to that of mammography, and found that a greater proportion of invasive and node-negative cancers were found in those who underwent ultrasound. However, they also saw a greater number of false-positives among the women screened with ultrasound. Although the false-positive rate is higher with ultrasound than with mammography, the number of women recalled for extra testing becomes more comparable on incidence screening rounds.

Overall, the researchers found that 32 percent of more than 2,500 women without cancer were asked to come back for additional testing at least once after an ultrasound. That compared to 23 percent of women who’d had mammography, the study said.

The findings suggest that for women who don’t have a high risk of breast cancer but have dense breasts, “we find many more cancers if we do ultrasound in addition to mammography,” study leader Dr. Wendie Berg, professor of radiology at Magee-Womens Hospital of UPMC in Pittsburgh. Berg said the cost of mammography and ultrasound are comparable in the United States. “The issue is: what are the cancers we most need to find,” she said. “The cancers you need to find are the invasive, node-negative ones. More of the cancers found with ultrasound were invasive and node-negative than those found with mammography.”

“Where mammography is available, ultrasound should be seen as a supplemental test for women with dense breasts who do not meet high-risk criteria for screening MRI and for high-risk women with dense breasts who are unable to tolerate MRI,” stated the authors. The study was published Dec. 28 in the Journal of the National Cancer Institute.

About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Digital Mammography Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA.