Ultrasound helps catch cancer in higher-risk women

Adding an ultrasound to annual mammograms for women at higher-than-average breast cancer risk helps catch more early-stage tumors - but also ups the chance that healthy women will get follow-up biopsies unnecessarily, according to a new study.

For most women who fit into an "intermediate-risk" category - including those with very dense breasts, or who have a family member with breast cancer - the extra chance of false positives and more testing is probably worth it, said the study's lead author.

That's because along with those women's higher chances of getting cancer, mammograms may not work as well on women with denser breasts, for example.

"The vast majority... of women who are well aware of these risks would still gladly choose to have the ultrasound, knowing that it increases the chance of finding cancer if it's present and finding it early," said Dr. Wendie Berg, from Magee-Womens Hospital in Pittsburgh.

Still, one researcher not involved in the study questioned whether that was feasible, or even a good idea.

Recommendations from cancer and radiology organizations call for women who are at high risk of cancer, including those with BRCA1 and BRCA2 gene mutations, to get magnetic resonance imaging (MRI) in addition to annual mammography.

But guidelines haven't specified whether extra tests are also the best option for those in the intermediate-risk category - which may include up to 30 percent of women, Berg said.

"Anything that we propose to be extra in them, that's a lot of women," she told Reuters Health.

Berg said adding annual MRIs - which start at about $500 each - isn't such a practical or cost-effective option, and many people feel claustrophobic during the procedure or just don't like it. So she and her colleagues wanted to see if ultrasounds, which are less bothersome and run for under $100, might be an alternative addition to mammography.

Their study involved about 2,700 women seen at 21 different sites. More than half of those women had a history of breast cancer themselves - which also puts someone in the intermediate-risk category.

Every year for three years, women had both a mammogram and an ultrasound to check for signs of cancer. Finally, the researchers offered participants one MRI as a final check.

Over the study period, there were 111 new cases of breast cancer, 59 of which were picked up during mammography. Another 32 tumors that weren't spotted on mammograms were found with ultrasound - 30 of which were invasive cancers, according to findings published in the Journal of the American Medical Association.

Out of 612 women who opted for MRI, nine more cancers that hadn't shown up on other screening tests were detected. Eleven cancers were diagnosed at some point during the study through means other than screening.