Breast Cancer Diagnosis Improved

Physician's First Watch for May 14, 2008
David G. Fairchild, MD, MPH, Editor-in-Chief

Adding Ultrasound to Mammography Identifies More Cancers — but Also Yields More False-Positives

Ultrasonography, when added to mammographic screening, increases the number of breast cancers found in high-risk women — but at the cost of increased false-positives — researchers report in JAMA.

More than 2600 high-risk women underwent both mammography and ultrasonography, in random order. If either test was positive, then both results were examined and interpreted together. By 1-year follow-up, 40 participants were diagnosed with breast cancer, 8 of whom tested negative with both techniques.

Of the cancers detected during screening, mammography's diagnostic yield was 7.6 per 1000 women screened; when combined with ultrasound, the yield was 11.8. Mammography's false-positive rate was 4.4%; ultrasound's, 8.1%; and for combined modalities, 10.4%.

An editorialist writes that despite the high number of false-positives, what high-risk women "probably fear most is a late diagnosis." That, she continues, is "the real threat they want to be protected against, not false-positive diagnoses."

JAMA article (Free)