A New Tool for the Detection of Early Stage Breast Cancer: Automated Whole Breast Screening Ultrasound

Guest Author: Dr. Mark Ludka, Diagnostic Radiology, Advanced Diagnostic Imaging, PC

Over the past few years, there has been growing interest in both the radiology literature and lay press regarding mammographic breast density and how it relates to breast cancer. Evidence shows Automated Whole Breast Screening Ultrasound (AWBUS) to be an important new tool for detecting early stage breast cancer in women with dense breasts and/or implants.


Screening and Detection
Screening mammography has a long track record of significantly reducing breast cancer mortality, and remains the most effective breast cancer screening exam available today. Despite the steady improvement in technology over the years, mammography is not a perfect screening exam. Breast imagers have long known the limitations that dense breast tissue places on detecting abnormalities with mammograms.

More recently, there has been mounting evidence that dense breast tissue not only makes cancer harder to detect but is also associated with an increased risk of its development. Some studies have shown the risk of developing breast cancer to be increased by up to three-fold in women with extremely dense breasts. Overall mammographic sensitivity, or the percentage of breast cancers found when breast cancer is present, is often quoted at 85-90 percent. However, this percentage drops to 50 percent in women with extremely dense breasts.

There is now strong evidence that supplemental breast ultrasound screening performed on patients with dense breasts significantly increases cancer detection rates. AWBUS has been shown to double the cancer detection rate in dense-breasted women. It should also be noted that cancers hidden on mammography but detected with a screening ultrasound tend to be smaller and more likely curable

Availability
The Covenant Breast Health Center now offers AWBUS as a supplemental screening exam for women with dense breasts and/or implants, and is the first medical facility in Michigan to do so. The hospital’s mammography reports now include a statement describing the patient’s breast density. AWBUS is recommended, in conjunction with screening mammography, in patients with heterogeneously or extremely dense breasts. Because AWBUS is a screening procedure like mammography, those women who have an abnormality detected will be called back for a more detailed, targeted ultrasound exam to determine the need for follow-up or biopsy. The call-back rate is typically around 10 percent, similar to the call-back rate for screening mammography.

A Simple Procedure
AWBUS is a painless procedure using a standard ultrasound machine with the probe attached to an automated arm which scans each breast in vertical rows. There is no breast compression needed and the exam takes about 20 minutes to perform. Areas typically difficult or impossible to visualize using traditional mammograms are included in the field of view, which provides yet another benefit.

Please note that AWBUS is not a stand-alone procedure or a replacement for annual screening mammography. It is a supplemental exam that can be scheduled and performed at the same time as, or following, the annual mammography. Furthermore, AWBUS is not intended for evaluation of specific breast signs or symptoms. That is done using diagnostic mammography and targeted (hand-held) breast ultrasound.

Posted Date: 5/4/2015