Breast Ultrasound Detects Tumors in Women with Dense Breasts Overlooked on Mammography

Breast ultrasound screening performed following mammography on women with greater than 50% breast density identifies an additional 3.4 tumors or high-risk lesions per 1,000 women screened, a detection rate just under that of screening mammography by itself for women with less dense breasts, new findings revealed. Screening mammography detects four to five tumors per 1,000 women screened.

The study, conducted in conjunction with seven Connecticut radiology practices, included 19,745 women who had dense breasts and “normal” mammograms. Sixty-seven tumors were found, according to Dr. Sarah Steenbergen, lead author of the study, who is now at Yale University (New Haven, CT, USA). “Out of the available surgical reports, only one case had nodal involvement at the time of diagnosis. This suggests that the cancers are detected early and therefore we anticipate a survival benefit,” Dr. Steenbergen said.

The study has been conducted over a two-year period, “and we’ve seen an improvement in the sensitivity of screening breast ultrasound from 96.6%–100% and in specificity from 94.0%–96% from the first to the second year,” Dr. Steenbergen said. This reveals a learning curve, and “we anticipate that as the number of screening breast ultrasounds increase, physicians will be even better able to differentiate benign from malignant lesions,” she said.

Recent legislation in the US state of Connecticut mandates reporting of breast density on mammograms and recommending follow-up screening ultrasound for women with greater than 50% breast density, said Dr. Steenbergen. The study was done partly to gauge the outcome of this legislation and what they can expect to accomplish with screening breast ultrasound, she reported.

Dr. Steenbergen presented her study at the American Roentgen Ray Society (ARRS) annual meeting April 2013 in Washington DC (USA).

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