Breast Cancer Health

Annual breast ultrasound / MRI benefits women: RSNA 2009

The results of a large clinical trial presented at the annual meeting of the Society North American Radiation (RSNA 2009) provided the first solid evidence of the benefits of annual ultrasound screening for women with dense breasts who are at increased risk of breast cancer. In addition, the study confirms that MRI is very sensitive in the depiction of early breast cancer.

"We found that annual screening with ultrasound plus mammography significantly improves the detection of early breast cancer, "said lead researcher Wendy A. Berg, MD, Ph.D., a specialist in breast imaging at American Radiology Services, Johns Hopkins University - Green Spring Station in Lutherville, Maryland, "and that breast cancer significantly earlier can be found when an MRI performed, even after screening with ultrasound and mammography. However, ultrasound and magnetic resonance imaging increases the risk of false positives. "

Women who are at high risk of cancer breast should begin testing at a younger age and often develop cancer earlier than women at average risk. However, women under 50 have more likely to have dense breast tissue, which may limit the effectiveness of mammography as a screening tool.

Multicenter trials have shown that MRI allows radiologists to accurately identify tumors missed by mammography and ultrasound. The American Cancer Society recommends that some groups of women at high risk of developing breast cancer should be screened with MRI, in addition to their yearly mammogram after age 30. However, MRI is not for everyone.

"Because the MRI test is very expensive and requires intravenous contrast, is something that is only recommended for the detection about 2 percent of women who are known or suspected carriers of mutations of BRCA1 or BRCA2 or have other unusual circumstances that put them at increased risk of cancer breast cancer, "said Dr. Berg.

"There are another 10 percent to 15 women who are at some risk because of personal history of cancer breast cancer family history of breast and / or dense breast tissue, "he added." For many of these women, MRI is not justified, but ultrasound appropriate annual, in addition to mammography. "

The researchers studied 612 women, average age 55, high risk breast cancer at 14 sites in the American College of Radiology Imaging Network (ACRIN) 6666 trial funded by the Avon Foundation and the National Cancer Institute. The women underwent mammography and ultrasound screening of reference follow-up examinations at 12 and 24 months and then a single, contrast-enhanced MRI at 24 months.

Sixteen women were diagnosed with breast cancer. Twelve of the cancers were invasive and four were ductal carcinoma in situ (DCIS). During the study, 50 to 56 percent of cancers are shown in the mammogram. Adding ultrasound allowed detection of 70 to 94 percent of cancers. Addendum MRI allows for the detection of additional cancers in their earliest stage.

The study also found that additional detection with ultrasound or MRI significantly increased the risk of false positive results, leading to unnecessary biopsies in some women.

"It important that women are informed about the possible increase to undergo an unnecessary biopsy as a result of evaluation with ultrasound or MRI, "said Dr. Berg, "but we hope this study encourages women and their physicians to learn more about their risk factors and to undergo additional tests, as well of a mammogram where indicated. "

About the Author

For more information about RSNA, and RSNA 2009.Please visit Radiological Society of North America at http://www.medicexchange.com/

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