Who Should Get More Than Mammograms to Screen for Breast Cancer?

->Dense breast tissue may make it more challenging to spot breast cancer symptoms on a mammography.

->An additional ultrasound screening can aid in the earlier diagnosis of breast cancer.

->A recent study has discovered that the women who are most at risk do not always receive this additional screening.

->Although breast density is a risk factor, it's crucial to take other factors into account as well.

->Women who have a high risk of having a mammogram fail should think about further screening.

Breast cancer risk is increased by dense breast tissue. It makes it more challenging to see cancer on a mammogram, making it possible to miss crucial diagnosis.

Currently, doctors in most states are mandated to inform you if you have thick breast tissue, which is defined as having proportionally more fibrous tissue than fat in your breasts. This gives women the option of getting supplemental ultrasound screening.

According to the authors of a new study, there are some potential downsides to further tests, which was recently published in the journal CANCER Trusted Source

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Why further screenings may be problematic

First off, more imaging is required, which adds to the time and cost.

Additionally, additional ultrasounds increase the possibility that people will get unnecessary breast biopsies.

The authors emphasize the need to make sure that only women who are more likely to have their breast cancer diagnosis missed are receiving additional ultrasound screening.

Their study's objective was to weigh the advantages and disadvantages of these additional screenings.

The American College of Gynaecology and Obstetrics updated its recommendations for medical professionals and reaffirmed that women with thick breasts who do not have any other cancer risk factors might not require further examinations.

"While ACOG does not recommend routine use of alternative or adjunctive tests to screening mammography in individuals with dense breasts who are asymptomatic and do not have additional risk factors, ACOG recommends that clinicians comply with the new FDA rule as well as any state laws and federal rules that require disclosure of a patient's breast density as recorded in a mammogram report," the authors wrote.

Although ACOG does not often advise using alternative or adjunctive Many women do not receive the necessary screenings.

The capacity of ultrasound to visualize the breast in a different way can give clinicians additional information, according to Dr. Blen Tesfu, a general practitioner and medical advisor for the UK-based healthcare platform Welzo.

She stated that it "can detect small abnormalities that might not be visible on mammograms alone," potentially resulting in earlier diagnosis and better results for women who are at higher risk.

Because there are no national guidelines for whether to employ additional screening following a mammogram, lead author Dr. Brian Sprague explained that he and his colleagues were interested in researching this subject.

Nevertheless, he pointed out, "breast ultrasound screening has been used more frequently over the past ten years in the U.S. This is partly because more people are becoming aware of the limitations of mammography screening for women with mammographically dense breasts."

He and his team compared 825,360 screening mammography with supplemental ultrasounds against 38,166 supplemental ultrasounds to more closely study this subject.

The Breast Cancer Surveillance Consortium's three regional registries and 32 American imaging centres participated in their investigation, which took place between 2014 and 2020.

95.3% of supplemental ultrasounds were performed on women with thick breast tissue, according to their analysis of the data.

On the other hand, women with thick breasts underwent 41.8% of mammography without further ultrasonography screening.

A high risk of interval-invasive breast cancer affected 23.7% of the women who underwent supplemental ultrasound screening, which means that any cancer missed by the screening would be found before the subsequent regularly scheduled mammography.

In contrast, only 18.5% of women who had mammography did not receive further ultrasound imaging as a follow-up.

According to the National Cancer Institute Trusted Source, interval-invasive tumors frequently have a rapid rate of growth and spread along with being bigger. Additionally, their prognosis is worse.

These data, according to Sprague, show that ultrasound screening is poorly focused towards women who are at the greatest risk of a missed diagnosis and is instead heavily concentrated on women with thick breasts.

Choosing which individuals require additional screening

According to Tesfu, the results of this study suggest that women with thick breasts who are also at a high risk of having their mammograms rejected undergo supplementary ultrasound screening.

"Breast density and 5-year breast cancer risk calculated using prediction models may be factors to consider when determining high-risk status," she said.

The assessment will need to be done on a case-by-case basis, taking into consideration each woman's risk factors, preferences, and available resources, though, as there are presently no consensus criteria.

Sprague cited freely accessible risk calculators from the Breast Cancer Surveillance Consortium as tools for decision-making that take into account variables like age, family history of breast cancer, body mass index, breast density, among others.

"Women with breast cancer risk, and particularly those at high risk of a late stage breast cancer with mammography alone, should consider supplemental ultrasound screening," he suggested.

According to Tesfu, talking to your doctor or a breast specialist might help you decide what is right for you.