Breast Ultrasound Shown Superior for Women Under 40 With Focal Breast Symptoms

Leesburg, VA, October 19, 2018—Breast ultrasound should be used as the primary initial imaging modality in the evaluation of a focal clinical concern in women 30-39 years old, according to an upcoming article in the American Journal of Roentgenology (AJR).

The study showed that bilateral mammographic evaluation of women 30-39 years old presenting with breast symptoms yielded an additional 2.0 incidental cancers per 1000 examinations. Women with diagnoses of incidental breast cancer in this young population were at higher lifetime risk of breast cancer than their age-matched control subjects, nearly 70% presenting with identifiable risk factors.

The findings support American College of Radiology (ACR) and European recommendations for targeted breast ultrasound as the initial imaging evaluation of women 30-39 years old who have symptoms and support bilateral mammography added to ultrasound for women with risk factors for breast cancer and as an adjunct examination when suspicious or indeterminate sonographic findings are present.

The study reviewed more than 4,000 diagnostic examinations of women who underwent mammography and ultrasound between June 2006 and August 2016. Outcomes were determined by imaging and pathologic analysis through linkage with a tumor registry. Medical records were reviewed to determine the presence of breast cancer risk factors.

Of that group, 68 breast cancers were diagnosed for a cancer detection rate (CDR) of 15.4 per 1,000 examinations. Sixty examinations led to biopsy of a finding distant from the presenting symptom site, yielding nine incidental malignancies with a CDR of two per 1,000 examinations. In the study group, targeted breast ultrasound had 98.3% sensitivity for cancer detection in the symptomatic area with 100% negative predictive value. These results are consistent with previous research findings showing high sensitivity of targeted ultrasound in the evaluation of young patients with symptoms.

Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.