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Home > Resources > Research Dense Breast Tissue > Adding ultrasound to 2D or 3D mammography results in significant cancer detection otherwise masked by dense tissue

Adding ultrasound to 2D or 3D mammography results in significant cancer detection otherwise masked by dense tissue

May 3, 2017: Two recent papers presented at the American Roentgen Ray Society (ARRS) meeting demonstrate the important utility of adjunct ultrasound screening in dense breasts after mammography (both 2D and 3D/Tomosynthesis). As reported by AuntMinnie.com, "ARRS:  Don't underestimate breast US in cancer arsenal" By Kate Madden Yee, researchers from Elizabeth Wende Breast Care in Rochester, NY revealed that ultrasound increased the detection of breast cancer in women with dense breast tissue, outperforming digital breast tomosynthesis/3D mammography.  

Dr. Stamatia Destounis compared the performance of ultrasound alone, ultrasound after 3D, and 3D alone. 10,412 screening ultrasound exams were performed on patients with heterogeneously and extremely dense breast tissue, of which 7,146 also had 3D mammography.

Thirty-nine cancers were identified in patients with dense breast tissue.  3D alone found 4 cancers (3 high grade DCIS, one invasive), ultrasound alone found 17 cancers (13 invasive) and 18 cancers were discovered using both 3D and Ultrasound. Average lesion size was 2.7cm with 3D, 1.5cm w/DBT plus ultrasound and 1.3 with ultrasound alone. Dr. Destounis reported that the 17 cancers that were invisible by 3D, yet seen by ultrasound, ten were in heterogeneously dense breasts and seven in extremely dense breasts.  Dr. Destounis spoke to Aunt Minnie and reported, "Seventeen cancers were found on ultrasound alone. If we had only performed tomosynthesis we would have missed these."

In the second presentation from North Shore University Health System, Dr. Georgia Giakoumis-Spear discussed findings from a study involving Automated Breast Ultrasound (ABUS) as an adjunct in women with dense tissue. ABUS was implemented in women with dense breast tissue (Birads C,D).  All the women were asymptomatic and had a negative screening (normal) mammogram with the year.  ABUS detected 6 (<1.5cm) node-negative invasive cancers for a detection rate of 12 per 1000. 

"These results were astonishing to us," reported Dr. Giakoumis-Spear to Aunt Minnie. Dr. Giakoumis-Spear also added that the recall rate was very low, with a call-back rate of 7%.

Take Home Lesson:  If you have dense breast tissue and have received a recent 'NORMAL' 3D or 2D mammography result, discuss with your health care providers adding ultrasound or MRI (if high risk) to your yearly screening mammogram.

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  • Are You Dense? Fact #1:

    Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.

     
  • Are You Dense? Fact #2:

    Two-thirds of pre-menopausal women and 40% of post-menopausal women have dense breast tissue. 

     
  • Are You Dense? Fact #3:

    Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.

     
  • Are You Dense? Fact #4:

    American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.

     
  • Are You Dense? Fact #5:

    While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with dense breasts.

     
  • Are You Dense? Fact #6:

    A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.

     
  • Are You Dense? Fact #7:

    Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.

     
  • Are You Dense? Fact #8:

    A substantial proportion of Breast Cancer can be attributed to high breast density alone.

     
  • Are You Dense? Fact #9:

    Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.

     
  • Are You Dense? Fact #10

    There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.

     
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