AB US Plus Screening Mammography Detects More Cancers

Adding automated breast (AB) ultrasonography (US) to screening mammography increases cancer detection among women with dense breasts, according to a study published in the journal Radiology.

Researchers from the United States, Sweden, and the United Kingdom undertook an observational, multicenter study, called the SomoInsight Study, to determine improvement in breast cancer detection by using supplemental 3D AB US with screening mammography versus screening mammography alone in asymptomatic women with dense breasts.

A total of 15,318 women (mean age of 53.3) who presented for screening mammography alone with heterogeneously (50% to 75%) or extremely (more than 75%) dense breasts were included in the study, regardless of further risk characterization. The participants were followed up for one year. All participants underwent screening mammography alone followed by an AB US examination.

The results showed that 112 women were diagnosed with breast cancer. Of these women, 82 were diagnosed with screening mammography and 30 with AB US, resulting in an additional 1.9 detected cancers per 1,000 women screened by using AB US. Of cancers detected with screening mammography, 62.2% (51 of 82) were invasive versus 93.3% (28 of 30) of additional cancers detected with AB US.

In addition, 17 of the 82 cancers detected with either mammography alone or the combined read were detected with screening mammography alone. Eleven of the 17 (64.7%) were ductal carcinoma in situ versus two of 30 (6.7%) of cancers detected with AB US alone. Sensitivity for the combined read increased by 26.7%.

The corresponding recall rate per 1,000 women screened was 150.2 for screening mammography alone and 284.9 for the AB US.

The researchers concluded that by adding AB US to screening mammography for women with dense breast tissue, physicians could increase cancer detection of clinically important cancers, although there is also an increase in the number of false-positive test results.