Screening When Breasts are Dense
Many women who recently learned they have dense breast tissue may not know that extra screening can save lives.
Dense breast tissue shows up whiter than fatty breast tissue, which makes it harder to spot the white lesions of early-stage breast cancer. This means cancer in dense breast may be discovered later, giving these women poorer survival outcomes.
A new study of 9,000 UK women questioned whether extra screening can find cancer and which types are best. The short answer is yes. There are three types of scans and they all beat regular mammograms. The Automated Breast Ultrasound uses 3D ultrasound technology to image the entire breast.
The AbMRI injects a dye before the patient gets a magnetic scan to produce high-resolution images of the breast and body. The last is Contrast Enhanced Mammography which is like a regular mammogram, but with an IV injection of iodine-based dye. It highlights abnormal blood vessels and hyperactive tissues that can happen with cancer.
The last two scans detected 85 cancers that regular mammograms missed. The MRI and iodine mammogram also found three times as many invasive cancers as the whole breast ultrasound. The tumors they found were also smaller, which means they can detect early-stage cancer. That can lead to better outcomes.
Researchers predict adding the two scans would detect 3,500 more cancers a year in the UK, saving an extra 700 lives. Talk with your doctor about getting extra scans if you have dense breast tissue.
More Information
Comparison of supplemental breast cancer imaging techniques—interim results from the BRAID randomised controlled trial
It is not known which supplemental imaging technique is most beneficial for women with dense breasts attending breast screening. This study compares abbreviated MRI, automated whole breast ultrasound (ABUS), and contrast-enhanced mammography versus standard of care in women with dense breasts and a negative mammogram. We report on interim results from the first round of supplemental imaging.
Pros and Cons for Automated Breast Ultrasound (ABUS): A Narrative Review
Automated breast ultrasound (ABUS) is an ultrasound technique that tends to be increasingly used as a supplementary technique in the evaluation of patients with dense glandular breasts. Patients with dense breasts have an increased risk of developing breast cancer compared to patients with fatty breasts. Furthermore, for this group of patients, mammography has a low sensitivity in detecting breast cancers, especially if it is not associated with architectural distortion or calcifications. ABUS is a standardized examination with many advantages in both screening and diagnostic settings: it increases the detection rate of breast cancer, improves the workflow, and reduces the examination time.
Abbreviated Breast MRI: State of the Art
Abbreviated MRI is an umbrella term, defined as a focused MRI examination tailored to answer a single specific clinical question. For abbreviated breast MRI, this question is: "Is there evidence of breast cancer?" Abbreviated MRI of the breast makes maximum use of the fact that the kinetics of breast cancers and of benign tissue differ most in the very early postcontrast phase; therefore, abbreviated breast MRI focuses on this period.