In last month’s newsletter, I discussed KCBC’S position on “3D Mammography” there are advantages of breast ultrasound screening over “3D Mammography” despite the current craze over this 3D technique. First, to review “3D Mammography” it is not 3D imaging as it purports in its name. It cannot radiographically image the breast in all 3 dimensions. It still is 2D Mammography but takes multiples slices radiographically in 2 dimensions.
Secondly, the European trial, “ASTOUND Study” demonstrated that standard 2D Mammography which we are all familiar with and breast ultrasound screening found more breast cancers than “3D Mammography” alone.
A study was published in August in Radiology, one of the leading, well-respected monthly radiology journals, by Dr. Soo-Yeon Kim and colleagues from South Korea. The study commenced in January 2004 and was completed in March of 2011. The study included 501 women with breast cancer identified with breast screening ultrasound. Only 15.8% * of these women had high-risk factors for breast cancer. Their results showed that women with dense breasts whose mammograms were negative were also found to have their breast cancers detected on breast ultrasound screening, and had a five-year survival rate of 100% and a recurrence-free survival rate of 98%. They concluded that these results cement breast ultrasound’s important place in the arsenal of breast cancer screening tools. This is because the breast cancers were found when they were small and as a result a significant number of the breast cancers had not spread to local lymph nodes (90.8%) in the axilla. This is key to preventing spread of disease. These results have also been shown in American based studies as well. Keep in mind that women do not succumb to a breast cancer in the breast. This happens when the breast cancer spreads beyond the breast to vital organs. Therefore, it is important to find the breast cancer when it is small.
Additionally, 89% had a less aggressive breast conservation procedure due to the small size of the breast cancer.
It is important to screen women with mammographically dense breasts with breast ultrasound. There is no radiation exposure with breast ultrasound. These two imaging tools find significantly more numbers of breast cancer than “3D mammography” alone. “3D Mammography” has not proven itself to find small node negative breast cancers as of this date.
*15.8% the women in this study had high-risk factors for the developing breast cancer. This means that 84.2% of women were at low risk for developing breast cancer. Just as a reminder, breast cancer screening yearly for all women beginning at 40 is important because it is such a prevalent disease and is the number 1 cause of cancer in women in the U.S.