Improving Breast Cancer Detection in Higher Risk Women: A Multi-Modality Imaging Evaluation in a Private Screening...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• 2D mammography has reduced sensitivity in dense breasts, hindering early breast cancer detection.
• This study addresses the need for improved screening in high-risk populations.

Purpose of the Study:

• To evaluate the utility of supplementary multi-modality imaging (tomosynthesis, ultrasound, MRI) in a risk-stratified New Zealand population.
• To compare detection rates and disease extent assessment using various imaging techniques.

Main Methods:

• Retrospective case study of 2401 patients (May 2022-September 2023) in New Zealand.
• Patients stratified by Tyrer-Cuzick (TC) v8 lifetime risk and Volpara breast density.
• Multi-modality imaging included 2D mammography, tomosynthesis, supplementary ultrasound for dense breasts, and abbreviated MRI for high-risk scores (≥30%).

Main Results:

• Tomosynthesis detected 38% more invasive cancers than 2D mammography alone.
• Ultrasound and MRI identified an additional 27% of invasive cancers, primarily in women with dense (Volpara 'D') breasts.
• MRI demonstrated superior accuracy in assessing disease extent, including multi-focal and multi-centric disease.

Conclusions:

• Supplementary imaging, particularly MRI, significantly enhances breast cancer detection and staging in high-risk women.
• A personalized screening approach integrating risk assessment and breast density is supported.
• This facilitates optimal selection of imaging modalities for improved outcomes.