Scheel et al study published in AJOG, reports on their review from 189
studies of screening for breast cancer in women with dense breasts. From the total of 189 studies, 12 that
were conducted between January 2000 and April 2013 met the criteria set by the
researchers. The reporting of breast cancer risk factors varied across studies;
however, the populations studied tended to be at greater than average risk for
developing breast cancer.
Overall, ultrasound (US) detected an additional 0.3-7.7
cancers/1,000 examinations (Median 4.2) and was associated with an additional
11.7-106.6 biopsies/1,000 examinations (Median 52.2). They found that US screening for women with dense breast tissue
increases cancer detection and leads to fewer false positive biopsies compared
to mammography alone.
The researchers report that most of
the additional cancers identified by ultrasound were small and node-negative
stage. Such cancers can be curable and require less aggressive treatment
because of the early detection. They suggest physicians should discuss the use
of ultrasound as an adjunct to mammography with patients who have dense breast
tissues. They should explain the
benefits and also potential to lead to additional percutaneous biopsies in easy
to understand terms and arrive at a shared decision consistent with individual
patient’s preferences and values.
The analysis of data from the reviewed studies suggest that potential
benefits and harms could accrue if screening ultrasound is added to mammographic
screening of women with dense breast tissue.
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