Ultrasound Breast Cancer Screening, Not ready for Prime Time
A Report from the Radiological Society of North America on the Amer College of Radiology Imaging Network (ACRIN)6666 study;
1. A multicenter study of 2,637 women at high risk for breast cancer.
2. High risk was defined as a personal history of breast cancer (53%), familial high risk (42%), prior atypical ductal hyperplasia, atypical lobualr hyperplasia, lobular carcinoma in situ, or atypical papilloma (3%), BRCA1 or BRCA2 mutations (1%), or prior mediastinal/chest radiation therapy (1%)
A. The addition of screening ultrasound to mammography identified an additional 4.2 cancers per 1,000 high risk women screened.
B. In the study, 40 women were diagnosed with cancer, 15% of which were ductal carcinomain situ. Twelve (30%) of the women had cancers found by mammography alone, 12 (30%) by ultrasound alone, 8 (20%) seen by mammography and ultrasound, and 8 (12%) found by neither.
C. The vast majority of the cancers detected by ultrasound were small (median 10mm), and node negative (9/10).
D. The supplemental ultrasound screening resulted in additional biopsies in 136 (5.2%) women, of whom only 12 (8.8%) were found to have cancer.