Mammography, MRI Combined Best for High-Risk Screening Program
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Combining MRI and mammography in an organized breast screening program for high-risk women is effective.Cite
Alternating two screening modalities pays off for women with high genetic likelihood of breast cancer Alternating MRI with mammography every six months picks up breast cancers missed when mammography is performed alone for high-risk women.
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The aim of this review is to identify the evidence for the surveillance of women at high risk of breast cancer with the different modalities. The definition of high risk refers to the subpopulation of women with a family history of breast cancer, including both those with and without identified genetic mutations. The following topic has been evaluated: clinical breast examination (CBE), mammography, ultrasound and MRI accuracy of detecting breast cancer among women at high risk. The search was limited to full reports published in English and published between 1996 and March, 2010. We found consistent evidence that adding MRI provides a highly sensitive screening strategy (sensitivity range: 93-100%) compared to mammography alone (32-86%) or mammography plus ultrasound +/- CBE (26-93%). Three studies that compared MRI plus mammography versus mammography alone showed the sensitivity of MRI plus mammography as 93% (95% CI 86-100%) and the incremental sensitivity of MRI as 60%. Incremental sensitivity of MRI was lower when added to mammography plus ultrasound (43%) or to the combination of mammography, ultrasound plus CBE. Estimates of screening specificity with MRI were less consistent but suggested a 3-5-fold higher risk of patient recall for investigation of false positive results. No studies assessed whether adding MRI reduces patient mortality, interval or advanced breast cancer rates, even if we found strong evidence that MRI leads to the detection of earlier stage disease. This review suggests that a surveillance strategy would be accurate and effective in improving health outcomes for women at high risk of breast cancer, but randomized studies should be considered for a better evaluation of these topics. Keywords: breast MRI, high risk women, mammography, Surveillance, ultrasound, BRCA1, BRCA2, breast cancer, Combination Screening Strategies
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Still there is a passionate debate in medical world about the best screening method for Breast Cancer. Early detection is an effective way to diagnose and manage breast cancer. Mammography is the most widely used screening modality, with solid evidence of benefit for women aged 40 to 74 years. Even then it has also undergone increased scrutiny for False-Positives with additional testing which increase radiation dose, cost and anxiety. False-Negatives with false sense of security and potential delay in cancer diagnosis. To overcome these challenges, new imaging technologies for breast cancer screening have been developed, including; X- ray Mammography, Contrast Enhanced Mammography, Digital Mammography, Ultrasound, Automated Whole Breast Ultrasound (AWBU), and Magnetic Resonance Imaging (MRI) are being evaluated. The purpose of this paper is to provide an overview of different medical imaging techniques used in thediagnosis of breast cancer. We compare their effectiveness, advantages, and disadvantages for detecting early-stage breast cancer. We mainly focusing on the comparison of these technologies with mammography for the diagnosis of breast cancer. Here we recommend early detection of Breast Cancer. Even though the optimal screening will ultimately require a personalized approach. It based on the metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
Breast Cancer Screening
Digital Mammography
Breast imaging
Cancer screening
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Objective The present study is to evaluate the clinical value of a new breast image screening strategy:combination of ultrasound and mammography.Methods Including breast cancers detected by the breast image screening projects in Fudan University,Shanghai Cancer Center(FDSCC).Females over 40 years old,who took both mammogram and ultrasound at the screening time would be selected.Analyze the diagnostic sensitivity of mammography alone,ultrasound alone and mammography in combination with ultrasound.Furthermore,the sensitivity of mammography in combination with ultrasound and mammography alone were compared in all,and by different age groups and by different breast density.Results 42 breast cancers detected by screening meet the enrolling criteria.Respectively,the screening sensitivity of mammography alone,ultrasound alone and mammography combined with ultrasound was 81.0% 、64.3% 、 95.2%,the difference between mammography in combination with ultrasound and mammography alone was statistically significant(P0.05).The benefit of adding ultrasound to mammography as a new breast image screening strategy was found statistically significant in patients with dense breast on mammogram,while was not found in younger(50 years old) women(P0.05).Conclusions Mammography combined with ultrasound could increase the diagnostic sensitivity of breast screening.The combined image screening strategy could be recommended for women with dense breast on mammography.
Breast ultrasound
Breast Cancer Screening
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Breast ultrasound
Breast Cancer Screening
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Value (mathematics)
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Screening mammography
Mammography screening
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Digital Breast Tomosynthesis
Digital Mammography
Tomosynthesis
Breast Cancer Screening
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