Study: Conventional Mammography ‘Likely’ Misses More Than 50 Percent of Breast Cancer Diagnoses
Emerging research from the RSNA conference suggests that two-dimensional mammography would only detect 41 percent of detectable breast cancer.
Relying solely on two-dimensional (2D) mammography may miss up to 59 percent of detectable breast cancer, according to new research presented at the Radiological Society of North America (RSNA) conference.1
For the research, study author Matthew Covington, MD considered 40,538,610 screening mammograms performed in 2023 based off Mammography Quality Standards Act (MQSA) data, a 43 percent prevalence of dense breasts, according to the Breast Cancer Surveillance Consortium (BCSC), and an estimated 17,431,602 supplemental screening exams.
Noting 469,437 detectable cases of breast cancer in the 2023 screening population, Dr. Covington proceeded to compare the proportions of breast cancer detection for 2D mammography, digital breast tomosynthesis (DBT), ultrasound, molecular breast imaging (MBI), contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI). For these estimates, Dr. Covington noted a CDR of 4.7/1000 cases for 2D mammography based on BCSC data and utilized previously reported incremental cancer detection rates (ICDRs) for DBT (1.7/1000), 2.7/1000 for ultrasound, 8.1/1000 for MBI, 10.7/1000 for CEM and 16/1000 for MRI.1,2
The research revealed that 2D mammography would diagnose an estimated 190,531 out of 469,437 cases of breast cancer (41 percent).
New research estimates, presented at the RSNA conference, suggest that conventional two-dimensional mammography may only diagnose 41 percent of detectable breast cancer. (Photo courtesy of Adobe Stock.)
“It is likely that 2D mammography identifies less than half of all detectable cancers within the screening population,” noted Dr. Covington, an assistant professor affiliated with the Department of Radiology and Imaging Sciences at the University of Utah.
(Editor’s note: For related coverage from RSNA, click here.)
Dr. Covington emphasized that supplemental breast MRI would provide the most optimal detection of breast cancer in women with dense breasts. Supplemental CEM was estimated to diagnose 80 percent of breast cancer (377,049/469,437) and supplemental MBI may offer a 71 percent detection rate (331,727/469,437), according to the study.1
The study results indicated that supplemental DBT and ultrasound would be less effective with estimates of 47 percent and 51 percent, respectively, for detectable breast cancers.1
“Evaluating the efficacy of different breast cancer screening methods, inclusive and exclusive of supplemental dense breast screening, could offer significant insights for devising effective screening strategies,” maintained Dr. Covington.
References
1. Covington M. Maximizing breast cancer detection: a comparative analysis of screening strategies. Poster presented at the Radiological Society of North America (RSNA) 2024 110th Scientific Assembly and Annual Meeting Dec. 1-5, 2024. Available at: https://www.rsna.org/annual-meeting .
2. Berg WA, Rafferty EA, Friedewald SM, Hruska CB, Rahbar H. Screening algorithms in dense breasts: AJR expert panel narrative review. AJR Am J Roentgenol. 2021:216(2):275-294.
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