Ultrasound diagnosis of breast cancer, good or bad?

Researchers in the May 14, “Journal of the American Medical Association Index” reported that ultrasound combined with x ray photography can improve the diagnosis rate of breast cancer 28%.

However, false-positive rate than x ray photography alone three times higher! Therefore, these women had to accept this unnecessary biopsy.

Researchers say for sure that ultrasound and x ray photography of women in high-risk breast cancer diagnosis rate has improved greatly, especially those x ray photography showed increased breast density of women.

But the apparent false-positive rate and the lack of valid evidence (ultrasound unlike x ray, and CT and other imaging methods, to examine the experience of the very dependent, and different examiners may be drawn significantly different diagnosis, and it there is no effective long-term preservation, for people to identify evidence of retention) to limit the use of ultrasound, radiology experts, the study’s organizer Wendy. Berg said, she was an American Ivy League, John. Johns Hopkins University, Department of clinical radiology services, Dr., Ph.D..

“We have not done enough training of staff, so if you want to use ultrasound to check tomorrow, breast cancer, we can not do,” she said.

x ray photography, ultrasound, magnetic resonance imaging

The American Cancer Society now recommends that women with breast cancer risk factors besides x-ray photography screening, but also should be added to do magnetic resonance imaging (MRI).

The study results do not change the Cancer Society, the above recommendation, but ultrasound can be used as those who have risk factors, but there are magnetic resonance imaging (or MRI-guided biopsy) to check contraindications of women second choice. The American Cancer Society breast and cervical cancer Division Director Debbie. Sharon said.

“What is the high-risk women to do MRI contraindications, and no clear explanation,” she said, “We have a formal notice that these women can consider ultrasound examination, ultrasound examination, but do be sure to know that this check the high rate of false positives. ”

This study a total of 2637 women participated in these women were 21 cancer centers across the United States to do x ray photography examination, the result is increased breast density shadow.

Of these, half of the 2637 participants who previously received breast cancer treatment, most people have more than one immediate family member had had breast cancer.

In the 12 months of monitoring, there are 40 women were diagnosed with breast cancer patients, only half of these cancers are alone detected x ray photography, while the x ray photography combined ultrasound diagnosed a total of 31 patients.

40 cancer patients, there is neither a 9 by x ray photography, nor is it diagnosed by ultrasound, but after two years follow-up found.

Joint use of ultrasound and x ray photography of women, 1 / 10 after the women after breast biopsy proved to be false positives, and those who only accept x ray photography of women, only 40 individuals have been identified as a false positive. Berg said.

The study was funded by the U.S. National Cancer Organization and the Avon Foundation supports.

x ray photography still needs to

United States University of Bonn radiologists, clinical, Dr. Cristi. Kool-related comments published wrote: large-scale study confirmed the x ray photography in the diagnosis of breast cancer in women at high risk of poor performance, in particular those of women the breast is especially true of high-density shadow. However, in the foreseeable future, x ray photography of breast cancer screening will continue to be the basic means and tools. But it did more and more evidence suggests that the majority of women,, x ray photography can not make the most accurate diagnosis.

But Kull also said that x ray photography is the best tool for early diagnosis of breast cancer such as ductal carcinoma in situ. Therefore, it is still necessary, even if the ultrasound and MRI are widely used.

“Each breast was high-density shadow women should receive ultrasound,” she said, “It may not be used as screening tools, but the study tells us that it really useful.”

With regard to false-positive rates, said Steven Kull, although this annoying, but with the x ray photography false-positive rate than up, there can be any other explanation, because most of them are in the ultrasound-guided biopsy carried out.

Kull believes that although the x ray photography has been used for 40 years, but now it seems it could be considered out of the arena.

“Personal inspection plan according to individual risk profiles change, and how screening for breast cancer should be individualized,” she said, “Perhaps in the future, ultrasound or breast MRI will be the best choice.”