IN a new study from the University of Vermont, Larner College of Medicine, Burlington, Vermont, USA, researchers have highlighted the benefit of using ultrasound to image women with high-risk or advanced of invasive breast cancer.
Brian Sprague, University of Vermont, and colleagues set out to evaluate US screening outcomes for female patients with dense breasts and different estimated breast cancer risk levels. In a retrospective observational study, the team analysed data from US screening examinations in female patients with heterogeneously or extremely dense breasts conducted from January 2014 to October 2020, across 24 radiology facilities within the three Breast Cancer Surveillance Consortium registries. The primary outcomes were the cancer detection rate, false-positive biopsy recommendation rate, and positive predictive value of biopsies performed (PPV3).
Overall, this comprised 34,791 US screening examinations from 26,489 female patients (mean ag: 53.9 years ± 9.0 years [SD]). As highlighted by the author, the overall cancer detection rate per 1000 examinations was 2.0 (95% CI: 1.6, 2.4). Moreover, this rate was higher in patients with high versus low or average risk of 6-year advanced breast cancer (5.5 [95% CI: 3.5, 8.6] vs 1.3 [95% CI: 1.0, 1.8), respectively; P=0.003). The overall PPV3 was 6.9% (67 of 975; 95% CI: 5.3, 8.9) and was higher in patients with high versus low or average 6-year advanced cancer risk (15.0% [15 of 100; 95% CI: 9.9, 22.2] vs 4.9% [30 of 615; 95% CI: 3.3, 7.2]; P = .01). Interestingly, the authors noted similar patterns in outcomes were observed by 5-year invasive breast cancer risk.
“While ultrasound screening does require specific training and expertise, in general, it is a more widely available technology and has higher acceptance among women compared to MRI and other imaging modalities,” noted Sprague. Based on these findings, the authors recommended that policymakers and healthcare professionals consider supplemental screening recommendations.
Helena Bradbury, EMJ
Reference
Sprague BL et al. Performance of Supplemental US Screening in Women with Dense Breasts and Varying Breast Cancer Risk: Results from the Breast Cancer Surveillance Consortium. Radiol. 2024;312(2).
