Breast Density Changes the Breast-imaging Landscape

Cristen Bolan, MS


Appl Radiol. 2013;42(3):20-25. 

In This Article

Adjunct Imaging

Nonetheless, as such a large percentage of the screening population has dense or heterogeneous breast tissue, many radiologists believe mammography for those patients should be followed up with an adjunct imaging test, such as ultrasound or MRI.

A recent trial by ACRIN[5] reported that there is a significant breast cancer detection benefit of supplementing annual mammography screening with ultrasound in women at elevated risk due to dense breast tissue. The same study also found that a single screening MRI following 3 years of annual mammography and ultrasound screenings identified additional cancers.

"This and other studies confirm that mammography fails to see about half of the cancers present in women with dense breasts. These women tend to be diagnosed with more advanced cancers often detected clinically in the interval between annual mammography screenings," said Wendie Berg, MD, PhD, and Professor of Radiology at the University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, PA, and the trial's principal investigator.

She noted, "For women who have dense breasts, adding ultrasound to mammography will increase the chance of finding invasive cancer before it spreads to lymph nodes," said Dr. Berg.