Screening Ultrasound as an Adjunct to Mammography in Women with Mammographically Dense Breasts.

Publication Type:

Journal Article

Source:

American journal of obstetrics and gynecology (2014)

Keywords:

2014, July 2014, Public Health Sciences Division

Abstract:

There are potential benefits and harms of screening ultrasound (US) to supplement mammographic screening of women with dense breast tissue. We conducted a comprehensive literature review of studies assessing the efficacy of screening US to supplement mammography among women with dense breasts. From a total of 189 peer-reviewed publications on the performance of screening US, 12 studies were relevant to our analysis. The reporting of breast cancer risk factors varied across studies; however, the study populations tended to be at greater than average risk for developing breast cancer. Overall, 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). Significant improvements in cancer detection in dense breasts have been achieved with the transition from film to digital mammography. Thus adjunctive screening with ultrasound should be considered in the context of current screening mammography performance. Clinicians should discuss breast density as one of several important breast cancer risk factors, consider the potential harms of adjunctive screening, and arrive at a shared decision consistent with each woman's preferences and values.