Improving breast cancer detection with new automated breast ultrasound

Advancements in imaging technology are improving breast cancer screening accuracy and precision for those with dense breast tissue who are at average risk of the disease. In clinical studies, a supplemental screening called automated breast ultrasound has effectively detected cancers missed by mammography alone.

Dense breasts are normal and common. Breast density refers to the relative amount of glandular, connective and fatty tissue in the breast. The more fibrous and glandular tissue a woman has, the “denser” her breast tissue. About 40% of women (and 70% of Asian women) have dense breasts.

Women are more likely to have dense breasts if they are younger, have a lower body mass index or take hormone therapy for menopause.

Women with dense breasts are four to six times more likely to get breast cancer than those with fatty breasts. In fact, 71% of all breast cancers occur in dense breasts.

Mammograms remain the gold standard for detecting breast tumors and are the only way to tell whether a woman has dense breasts.

When a woman has a mammogram, the radiologist assigns a density to her breast tissue. Federal law requires that women be notified of their breast density along with their mammogram results.

While mammography is the first-line screening test, for many women with dense breasts, it may not be enough. This group of women may benefit from a secondary screening test.

GE’s Invenia ABUS 2.0 is the first FDA-approved ultrasound supplemental screening technology designed to detect cancer in women with dense breast tissue. The device uses sound waves, rather than radiation, to create 3D images of the breast.

According to the FDA, when used in addition to mammography, ultrasound screening can improve breast cancer detection by more than 35% over mammography alone. The challenge with mammograms is that dense breast tissue and cancer are both white on the image that is captured. This can cause a masking effect when radiologists search for tumors.

It’s a bit like looking for a snowball in a snowstorm.

When automated breast ultrasound is used, dense tissue is white and lesions are black, making them easier to see. Cancers found using ultrasound screening with mammography tend to be smaller, giving patients more treatment options and better outcomes.

A provider’s order is required for an automated breast ultrasound screening. If a woman knows she has dense breasts, she can ask her provider to place an order for the automated screening to be performed after her next mammogram.

If a woman learns that she has dense breasts at the time of her screening mammogram, the radiologist can order an automated breast ultrasound screening for her.

During the screening, the patient lies on her back. Gel is applied to each breast and an ultrasound probe, mounted on a motorized arm, will follow a precise pattern to capture images from different angles. Computer software creates a 3D picture of the breast tissue for a radiologist to review.

The exam takes 15 to 20 minutes, and results will be shared with a patient’s primary care provider and added to the patient’s electronic medical record.

Automated breast ultrasound is meant to be used in conjunction with mammography, supporting it as a vital tool in the detection of breast cancer for women at average risk of the disease. Supplemental breast ultrasound screening is not covered by insurance at this time.

Women with dense breasts who are at high risk (20% or greater lifetime risk) of breast cancer benefit from having both annual mammograms and annual MRI exams for screening, rather than ultrasound. Ask your primary care provider about the best breast cancer screening program for you.

Jennifer Bergin, MD, is a radiologist and member of ProHealth Care’s Breast Imaging Services team.