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Mammography plus sonography can help rule out breast cancer in patients with palpable lesions
April 14, 2008When mammography and sonography are used together to evaluate palpable breast lesions, they can rule out cancers in most patients, according to a recent study conducted by researchers at Baystate Health in Springfield, MA. However, uncommonly, malignancies cannot be diagnosed using this imaging protocol.
"We were interested in finding out just how effective mammography and sonography were, when used together, in excluding breast cancer in women with palpable findings," said Erica Tyler, MD, lead author of the study. "Our study differs from others because after enrollment, we followed patients for at least 3 years to see if any of the palpable lumps later were diagnosed as malignant," she said.
The study evaluated 414 palpable breast lesions using both mammography and sonography. Imaging of 167 lesions was negative, with normal appearing breast tissue in the area of clinical concern and no mammographic or sonographic findings to explain the palpable finding. Among the 167 women with negative mammography and sonography, 120 reached a diagnostic endpoint with 28 patients undergoing a biopsy that showed no malignancy and 92 patients showing no malignancy after follow-up of at least 36 months. There were 118 true-negative and two false-negative cases said Dr. Tyler. The NPV when using mammography and sonography together was 98%, she said.
The study showed that both false-negative lesions "became increasingly suspicious on clinical exam and later became apparent by imaging," said Dr. Tyler. One false-negative lesion occurred in a patient with heterogeneously dense tissue and was diagnosed 74 months after initial clinical discovery. The second false-negative lesion occurred in extremely dense tissue and was diagnosed 81 months after initial discovery.
"Our findings support those reported in other studies. Uncommonly, palpable malignancies may not be detectable on both mammography and sonography, and this combination of imaging doesn't rule out malignancy," said Dr. Tyler. "Also, based on our findings, long term clinical and imaging follow-up of over five years may be needed to diagnose all palpable cancers, when the initial mammogram and sonogram are unrevealing," she said.
American Roentgen Ray Society
The study showed that both false-negative lesions "became increasingly suspicious on clinical exam and later became apparent by imaging," said Dr. Tyler. One false-negative lesion occurred in a patient with heterogeneously dense tissue and was diagnosed 74 months after initial clinical discovery. The second false-negative lesion occurred in extremely dense tissue and was diagnosed 81 months after initial discovery.
"Our findings support those reported in other studies. Uncommonly, palpable malignancies may not be detectable on both mammography and sonography, and this combination of imaging doesn't rule out malignancy," said Dr. Tyler. "Also, based on our findings, long term clinical and imaging follow-up of over five years may be needed to diagnose all palpable cancers, when the initial mammogram and sonogram are unrevealing," she said.
American Roentgen Ray Society
Mammography Current Events and Mammography News RSSScientists uncover new key to the puzzle of hormone therapy and breast cancer
The use of postmenopausal hormone therapy has decreased over time in the United States, which researchers suggest may play a key role in the declining rate of atypical ductal hyperplasia, a known risk factor for breast cancer.
Researcher: 'Optical biopsy' for breast cancer increasingly accurate
But women may not have to endure the medical costs, stress and potential complications that accompany such invasive biopsies forever. A University of Florida biomedical engineering researcher is making progress on an "optical biopsy" that has the potential to determine whether growths are cancerous without ever puncturing the skin.
URI research couple's method targets cancerous tumors
Two University of Rhode Island associate professors, biophysicists Yana Reshetnyak and Oleg Andreev, have discovered a technology that can detect cancerous tumors and deliver treatment to them without the harming the healthy cells surrounding them, thereby significantly reducing side effects.
Study finds delay in follow-up among African-American women receiving abnormal breast finding
A new analysis has identified a significant delay in follow-up times among African-American women after the finding of a suspicious breast abnormality.
New data: Hospital imaging centers poised to pull back, hitting patients hardest in rural areas
Survivors and patients with cancers and heart disease, along with patient advocate organizations and physicians, today urged policymakers to enhance early diagnosis of deadly diseases by preserving access to advanced imaging, such as MRI and CT scans, in final health care reform legislation.
Breast tenderness during hormone replacement therapy linked to elevated cancer risk
Women who developed new-onset breast tenderness after starting estrogen plus progestin hormone replacement therapy were at significantly higher risk for developing breast cancer than women on the combination therapy who didn't experience such tenderness, according to a new UCLA study.
Breast cancer patients with high risk gene diagnosed 6 years earlier than generation before
Women with a deleterious gene mutation are diagnosed with breast cancer six years earlier than relatives of the previous generation who also had the disease and/or ovarian cancer, according to new research from The University of Texas M. D. Anderson Cancer Center.
Researchers fine-tune Diffuse Optical Tomography for breast cancer screening
Clemson University researchers in collaboration with researchers at the University of Bremen, Germany, are working to make the physical pain and discomfort of mammograms a thing of the past, while allowing for diagnostic imaging eventually to be done in a home setting.
Surgeons' unanimous consensus: Needle biopsy is gold standard for breast cancer diagnosis
A special report published in the October issue of the Journal of the American College of Surgeons indicates that an alarming 35% of initial diagnostic breast biopsies in the United States are still being done using unnecessary open surgical techniques.
Researchers believe hormone therapy should not be stopped prior to mammograms
Researchers from Boston University School of Medicine (BUSM) are recommending that menopausal women on hormone therapy (HT) continue their treatment prior to having their annual mammogram screenings.
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