Dec. 2, 2009 (Chicago) -- Adding ultrasound to annual mammograms
improves the detection of early-stage breast cancer in women who are
at high risk for the disease, researchers say.
Ultrasound plus mammography, performed annually
for three years, spotted about 30% more cancers than mammography alone, says
Wendie A. Berg, MD, PhD, of American Radiology Services at Johns Hopkins-Green
Spring Station in Lutherville, Md.
"Importantly, most of the cancers that we found with ultrasound were the
small invasive cancers that are likely to spread and could ultimately kill a
person," she tells WebMD.
Berg says that use of MRI imaging further improved cancer detection in high-risk
The study of more than 2,800 women was presented at the annual meeting of
the Radiological Society of North America.
The research builds on a 2008 study, also led by Berg, that showed that a
single screen with ultrasound and mammography improves the detection of early
breast cancers over a mammogram alone in women at increased risk for breast
The new study sought to determine if detection could be further improved by
performing annual screens with both tools for three years.
"One of the issues that had never been looked at was whether we had to do
ultrasound every year or whether you would catch them the first time you
looked," Berg says.
The new study showed "that we could increase detection significantly with
each annual screening, so it does help to do ultrasound each year in addition
to the mammogram," she says.
Annual Ultrasounds Improve Breast Cancer Detection
The study involved 2,809 women at increased risk for breast cancer due to
dense breasts, having a breast cancer gene, or family history of breast
Dense breast tissue is not only a known risk factor for breast cancer, but
also makes it harder to spot cancer on mammograms.
About a third of the mammograms that were done the first year were digital;
this increased to 52% by the third year.
A total of 111 women were diagnosed with cancer over the three-year
Combined screening with mammography plus ultrasound found 82% of the
cancers, compared with only 53% for mammography alone, Berg says.
Nine of the cancers that were not detected with combined screening were
found when MRI was offered in the third year of the study.
"Having digital mammography didn't improve the detection rate [over film
mammography]," Berg says.
MRI Spots Even More Breast Cancers
The researchers also used MRI to scan a subset of 612 patients in the third
year of the study.
"MRI increased the cancer detection rate by another 56%," she says.
While the number of women studied with MRI was relatively small, this shows
that "if you really want to find as many of the cancers as you possibly can,
doing the MRI was even more sensitive, by far, than the combination of
mammography and ultrasound," Berg says.