Researchers in the UK conducted a randomized trial comparing various supplemental imaging techniques for breast cancer detection in women with dense breasts. The study revealed that abbreviated MRI and contrast-enhanced mammography outperformed automated whole-breast ultrasound (ABUS) in identifying breast cancers, particularly invasive tumors, which were detected at smaller sizes.
The trial, known as Breast Screening – Risk Adaptive Imaging for Density (BRAID), was led by Prof Fiona J Gilbert from the Department of Radiology at the University of Cambridge and involved ten breast screening sites across the UK. Women aged 50–70 with dense breasts and normal mammograms were randomly assigned to receive different imaging methods, including abbreviated MRI, ABUS, contrast-enhanced mammography, or standard digital mammography.
Between October 2019 and March 2024, 9,361 women participated in the study, with 6,305 undergoing additional imaging. Abbreviated MRI detected 17.4 breast cancers per 1,000 examinations, while contrast-enhanced mammography identified 19.2 cancers per 1,000 examinations, compared to ABUS, which detected 4.2 cancers per 1,000 examinations.
The findings indicated that invasive cancers were more effectively identified by abbreviated MRI and contrast-enhanced mammography, with smaller tumor sizes detected using these methods. However, the contrast-based techniques also led to higher recall rates, necessitating more follow-up procedures and potentially causing patient anxiety.
Despite the advantages of abbreviated MRI and contrast-enhanced mammography in enhancing early detection in women with dense breasts, the study authors highlighted the need for further research to evaluate the long-term benefits and risks, including the potential for overdiagnosis.
The researchers noted that the BRAID trial was the first to directly compare these supplemental imaging modalities in a randomized setting. They emphasized the importance of exploring the role of these techniques in breast cancer screening programs to improve outcomes for women with dense breasts.
While the study results showed promise in advancing breast cancer detection, the authors cautioned that more research is essential to fully understand the impact of incorporating these imaging methods into routine screening practices. They underscored the significance of balancing early detection with the risk of overdiagnosis to optimize breast cancer management.
Overall, the study findings suggest that supplementary imaging techniques like abbreviated MRI and contrast-enhanced mammography have the potential to enhance breast cancer detection in women with dense breasts, providing a valuable addition to existing screening strategies.
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