Ultrasound after mammography effective way for dense breast screening, reveals study

Ultrasound screening is an effective way to screen mammographically occult breast cancer in women with dense breast. On the other hand, digital breast tomosynthesis has gained much popularity as 3D mammography reduces the masking effect of overlapping breast tissue thus aiding in better cancer detection rates. In an ahead of print study in the American Journal of roentgenology, scientists have unveiled that ultrasound screening after digital breast tomosynthesis is not better than that of after digital mammography.

The previous studies have already demonstrated that adding ultrasound to mammography has no additional benefits in cancer detection and even it has benefits it is It is outweighed by the risk of overdiagnosis

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Lead investigator Elizabeth H. Dibble of Brown University and colleagues retrospectively searched databases at two tertiary breast imaging centers and office practice, focusing on 3183 screening breast US examinations performed from October 2014 to September 2016--1434 after DM and 1668 after DBT.

Of these 3183 examinations, 81 had no prior mammogram available. Of the 122 DM and DBT patients for whom biopsy or cyst aspiration was recommended--all BI-RADS assessment category 4 or 5 studies--118 had biopsy or cyst aspiration results available.

Of the 36 biopsies or aspirations after DM, 6 were malignant, and 30 were benign. Of the 82 biopsies or aspirations after DBT, 11 were malignant, and 71 were benign.

Overall, the additional cancer detection rate by the US after DM was 5/1434, or 3.5 per 1000 women screened; after DBT, the detection rate was 5/1668, or 3.0 per 1000 women screened.

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Dibble concluded: "Digital breast tomosynthesis does not obviate additional Ultrasound screening in women with dense breast tissue. No evidence was found of a difference in additional cancer detection rate with screening Ultrasound after Digital mammography versus after DBT. Knowing that the cancer yield of screening Ultrasound is similar after Digital breast tomosynthesis versus digital mammography may help inform clinical practice because questions abound about whether Digital breast tomosynthesis is sufficient screening for women with dense breast tissue."