Adding ultrasound to mammography may improve breast cancer detection in high-risk women

May 13, 2008

The addition of an ultrasound examination to mammography for women at high-risk of breast cancer resulted in a higher rate of cancer detection, but also increased the number of false-positive results, according to a study in the May 14 issue of JAMA.

Supplemental screening ultrasound has the potential of depicting small, node-negative breast cancers (when there is no cancer in the lymph nodes) not seen on mammography, according to background information in the article.

Wendie A. Berg, M.D., Ph.D., of the American Radiology Services Inc., Johns Hopkins Green Spring, Lutherville, Md., and colleagues conducted a study to compare the diagnostic effectiveness of screening breast mammography plus ultrasound vs. mammography alone in women at increased risk of breast cancer. The study included 2,809 women with dense breast tissue who were randomized to undergo mammographic and ultrasonographic examinations.

Forty participants (41 breast lesions) were diagnosed with cancer: 8 suspicious on both ultrasound and mammography; 12 on ultrasound alone; 12 on mammography alone; and 8 participants (involving 9 breast lesions) on neither.

The diagnostic yield for mammography was 7.6 cancers per 1,000 women screened (20/2,637); 31 cancers were diagnosed in 2,637 participants by the combination of mammography plus ultrasound, producing a yield of 11.8 per 1,000 women, and an increased yield due to ultrasound of 4.2 per 1,000 over mammography alone (or an additional 1.1 to 7.2 cancers per 1,000 high-risk women).

The diagnostic accuracy of mammography was 0.78; for ultrasound, 0.80; and for combined mammography plus ultrasound, 0.91. The positive predictive value of biopsy recommendation after full diagnostic workup was 19 of 84 for mammography (22.6 percent), 21 of 235 for ultrasound (8.9 percent), and 31 of 276 for combined mammography plus ultrasound (11.2 percent).

The false-positive rate for mammography was 4.4 percent; for ultrasound, 8.1 percent; and for combined mammography plus ultrasound, 10.4 percent.

“The detection benefit of a single screening ultrasound in women at elevated risk of breast cancer is now well validated. However, it comes with a substantial risk of false-positive results (i.e., biopsy with benign results and/or short interval follow-up). Our results should be interpreted in the context of recent guidelines recommending annual magnetic resonance imaging [MRI] in women at very high risk of breast cancer,” the authors conclude.

Citation: JAMA. 2008;299[18]:2151-2163.

Source: JAMA and Archives Journals

Explore further: Researcher to cancer: 'Resistance will be futile'

add to favorites email to friend print save as pdf

Related Stories

Microbiome may have shaped early human populations

5 hours ago

We humans have an exceptional age structure compared to other animals: Our children remain dependent on their parents for an unusually long period and our elderly live an extremely long time after they have ...

Big-data analysis reveals gene sharing in mice

5 hours ago

Rice University scientists have detected at least three instances of cross-species mating that likely influenced the evolutionary paths of "old world" mice, two in recent times and one in the distant past.

Recommended for you

Mutations need help from aging tissue to cause leukemia

41 minutes ago

Why are older people at higher risk for developing cancer? Prevailing opinion holds that, over time, your body's cells accumulate DNA damage and that eventually this damage catches up with the body in a way ...

Specific oxidation regulates cellular functions

5 hours ago

For a long time, hydrogen peroxide has been considered as a dangerous metabolite that can damage cells through oxidation. This, however, is not its only role in the cell. Scientists from the German Cancer Research Center ...

New disease mechanism discovered in lymphoma

5 hours ago

Programmed cell death is a mechanism that causes defective and potentially harmful cells to destroy themselves. It serves a number of purposes in the body, including the prevention of malignant tumor growth. ...

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

E_L_Earnhardt
not rated yet May 14, 2008
-AND HOW MANY CANCERS HAVE YOUR MAMMAGRAMS CAUSED?

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.