Contribution of ultrasound in detecting breast cancer in women with dense breasts and negative mammograms


The study analyses a prospective activity of ultrasound (US) screening of radiologically dense breast with negative mammography. The study confirms previous reports showing that US may detect additional mammography occult breast cancer with a substantial detection rate (around 0.3%). Whether this implies the recommendation of adding US to mammography in dense breasts as a current practice is not easy to say, as clinical studies deal with self referred women, often younger that 50 years. No doubt the benefits of US seem to be concentrated in younger women, were the incremental detection rate is quite high. The very high cost (compare to an average cost of 5,000 euros per screen detected cancer at mammography) is another obstacle. Decision on the current screening protocol need to be based on the results of ongoing conrolled trials in a screening setting (ACRIN, RIBES). In the mean time, on  an individual basis and at radiologist's judgement, US may be safely added to negative mammography with dense breast in self referring asymptomatic women informed that this might improve the detection rate of cancer at an acceptable cost in terms of unnecessary invasive assessments due to US false positives

 

 

Bibliographic Reference

Corsetti V et al.: "Breast screening with ultrasound in women with mammography-negative dense breasts: Evidence on incremental cancer detection and false positives, and associated cost", Eur J Cancer. 2008 Feb 9; [Epub ahead of print]

 

Stefano Ciatto

CSPO - Istituto Scientifico Prevenzione Oncologica, Firenze, Italy