Using a 3D mammography or ultrasound scan as well as a standard mammogram could detect breast cancers that would ordinarily be missed, delegates to a major conference have heard.
At the 10th European Breast Cancer Conference (EBCC-10) in Amsterdam, The Netherlands, Professor Nehmat Houssami, of the University of Sydney, Australia, said that interim analysis of a trial comparing these two additional screening technologies will have “immediate implications” for screening practice.
She told delegates that The Adjunct Screening with Tomosynthesis or Ultrasound in Mammography-negative Dense breasts (ASTOUND) trial of 3,231 women had found that including either of the extra scans had detected 24 cancers in women with dense breasts.
The interim analysis of data was undertaken from the women in Italy, all of whom had received negative mammograms.
The additional scans picked up an extra 24 breast cancers – 12 were detected by both tomosynthesis and ultrasound, one was detected only by tomosynthesis and 11 only by ultrasound.
“These results mean that tomosynthesis detected an additional four breast cancers per 1,000 women screened and ultrasound detected an additional seven breast cancers per 1,000,” said Prof Houssami.
The researchers, led by Dr Alberto Tagliafico, a radiologist and assistant professor of human anatomy at the University of Genoa, Italy, also found that, although there were an additional 107 false positive recalls, there were no difference in the additional false recall rate between tomosynthesis and ultrasound.
Professor Houssami added: “Given that tomosynthesis detected more than 50% of the additional breast cancers in these women, the implications are that it has the potential to be the primary mammography screening method without the need for an extra screening procedure.”
She said that further research in other settings, as well as cost analysis studies, were needed before definitive recommendations could be made.
Chair of EBCC10, Professor Fatima Cardoso, director of the Breast Unit at the Champalimaud Clinical Centre, Lisbon, Portugal, said: “Although further research is required, ASTOUND is the first prospective trial comparing additional screening technologies beyond mammogram in women with dense breasts. It provides important evidence of the potential benefit of ultrasound or tomosynthesis for screening women with dense breasts. Issues of cost effectiveness must, however, be addressed before we can change current screening practices.”
Abstract no: 3 LBA. “Interim results of the Adjunct Screening with Tomosynthesis or Ultrasound in Mammography-negative Dense Breasts (ASTOUND) trial”, Wednesday, Plenary session: keynote lecture and late breaking abstracts, 14.45-16.15 hrs, Elicium.
Tagliafico AS et al. Adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts: interim report of a prospective comparative trial. Journal of Clinical Oncology. DOI: 10.1200/JCO.2015.63.4147. [abstract]
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