Supplemental Breast Ultrasound Screening Outcomes Among Women With Dense Breasts
New BCSC study shows the importance of determining breast cancer risk
Dense breast tissue is a risk factor for breast cancer and also makes it more difficult for a radiologist to see breast cancer on a mammogram. There is widespread interest in supplemental screening technologies, such as whole breast ultrasound, that may detect breast cancers missed by mammography. However, there are concerns about false positive tests and unnecessary breast biopsies among women who do not have breast cancer. Brian Sprague, PhD, of the University of Vermont Cancer Center, and his colleagues evaluated outcomes data from 34,791 supplemental ultrasound screening exams among women with dense breasts at 24 U.S. imaging facilities within three regional registries of the Breast Cancer Surveillance Consortium. The team found that there was wide variation in screening outcomes according to the woman’s estimated risk of invasive and advanced stage breast cancer. The cancer detection rate was higher in women with high 6-year advanced breast cancer risk than in those with low/average risk (5.5 vs. 1.3 per 1000). The positive predictive value of biopsy was also higher in women with high vs. low/average advanced breast cancer risk (15.0% vs. 4.9%). Similar results were observed according to invasive breast cancer risk. The researchers concluded that screening strategies that target supplemental US for women with dense breasts based on advanced or invasive breast cancer risk may be expected to yield a high rate of cancers while limiting false-positive biopsy recommendations. Risk classification of participants was performed in the study using established BCSC risk prediction models of estimated 6-year advanced breast cancer risk and 5-year invasive breast cancer risk, which are publicly available (https://www.bcsc-research.org/tools).
Sprague BL, Ichikawa L, Eavey J, Lowry KP, Rauscher GH, O'Meara ES, Miglioretti DL, Lee JM, Stout NK, Herschorn SD, Perry H, Weaver DL, Kerlikowske K. Performance of Supplemental US Screening in Women with Dense Breasts and Varying Breast Cancer Risk: Results from the Breast Cancer Surveillance Consortium. Radiology. 2024 Aug;312(2):e232380. doi: 10.1148/radiol.232380. PMID: 39105648. [Link]
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