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Adding Ultrasound to Annual Mammograms Helps Detect More Breast Cancers: Presented at RSNA By Charlene Laino CHICAGO -- December 3, 2009 -- Adding ultrasound to annual mammograms significantly improves the detection of early-stage breast cancer in women who are at high risk for the disease, researchers reported here on December 1 at the Radiological Society of North America (RSNA) 95th Annual Meeting. Annual screening with mammography and physician-performed ultrasound, done annually for 3 years, detected 29% more cancers and 34% more invasive cancers than mammography alone, said Wendie A. Berg, MD, PhD, Radiology Services, Johns Hopkins at Green Spring Station, Lutherville, Maryland. The study builds on previous research by Dr. Berg and colleagues showing that a single screen with mammography and ultrasound significantly increased the detection rate of early-stage breast cancers by 4.2 per 1,000.(1) The new study, known as the American College of Radiology Imaging Network (ACRIN) 6666 trial, sought to determine if cancer detection could be further improved by performing annual screens with both tools for 3 consecutive years. The study involved 2,809 women at increased risk for breast cancer. Of those, 88% had dense breasts, 53% had a personal history of breast cancer, and 1% were carriers for the BRCA mutation. The women underwent a total of 7,473 screens. A total of 111 women were diagnosed with cancer, for a detection rate of 1.5% at 3 years. Combined screening with mammography plus ultrasound detected 82% of the cancers, compared with only 53% for mammography alone (P < .04), Dr. Berg reported. The median size of the tumours was 11.5 mm, (range, 1-55), and 10 (67%) of 15 were node negative. “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,” Dr. Berg said. As part of the study design, a subset of 612 patients was screened with magnetic resonance imaging (MRI) in year 3 of the study. “MRI increased the cancer detection rate by another 56% in that subgroup of patients, and increased the detection of invasive cancers by 67%,” Dr. Berg said. “Although the number of women studied was relatively small, MRI was even more sensitive than the combination of mammography and ultrasound,” she said. The major drawback to adding ultrasound or MRI screening was an increase in number of false positives, Dr. Berg said. But most women “say it’s not a big deal, that they would rather be sure there’s no cancer,” Dr. Berg said at a news briefing. 1. Berg WA et al. JAMA. 2008;299:2151-2163. [Presentation title: Screening Breast Ultrasound as a Supplement to Mammography: Yield of Annual Screening in ACRIN* 6666 *American College of Radiology Imaging Network. Abstract VB31-04 E-mail this page to a friend or colleague! To print, use this version