Breast ultrasound can detect even those neoplasms that were not shown by mammography in women with the so-called thick breasts – American scientists argue.
Mammography detects 4-5 cancers for every thousand women examined. It turns out, however, that in an ultrasound performed shortly after mammography in women whose breast density is more than 50%, an additional 3,4 neoplasms or other high-risk lesions were detected for every thousand patients examined.
Breast density is the term used to describe the nipple’s dense weaving. A “dense” breast is one in which the glandular tissue outweighs the adipose tissue. Meanwhile, the quality of a mammogram is strictly dependent on the mutual proportion of glandular and fatty tissue. Densely woven nipples are poorly X-ray transmissive, which results in less detectable nodules of any kind.
For some time it has been suggested that mammography is not a good diagnostic method for all women, precisely because of the differences in breast density, and some patients should undergo mandatory ultrasound, for which dense tissue is not an obstacle. Dr. Sarah Steenbergen of Yale University decided to verify this.
The study she led included 19 women who had previously had a mammogram and had high breast density. During the ultrasound examination, 745 neoplasms were detected, but the mammography did not reveal them. ‘These were early stage cancers and only one of these 67 cases had lymph node involvement,’ explains Dr Steenbergen. As she adds, the chances of recovery and survival of such patients were therefore high.
The study in question lasted two years. During this time, doctors managed to improve the sensitivity of breast ultrasound from 96,6 to 100%, and the specificity of the test from 94,0 to 96%. “We expect this effect to continue along with the increase in the number of women surveyed. The more ultrasound scans are done, the better we learn to distinguish between benign and malignant lesions, ”says Dr. Steenbergen.
The researcher hopes that over time it will be possible to introduce regulations requiring doctors performing mammography to report cases of all women with dense breasts (over 50%) and subject them to mandatory observation and additional ultrasound examinations.
kap/ ula/
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