WASHINGTON (AP) - Ultrasound exams can significantly increase the chance of detecting breast cancer early in some women, a radiologist said Thursday as he discussed his new study on the topic.
Small cancers can be hard to detect in women with dense breast tissue through mammograms or physical exams, Dr. Thomas M. Kolb told an American Medical Association science writers conference.
Women should be told how dense their breasts are, which only a mammogram can determine, Kolb said. Women with the most dense tissue may want to seek an ultrasound exam in addition to a mammogram, he said.
Kolb, a radiologist in private practice in New York, estimated that as many as 49 percent of women have dense breast tissue.
He said the study of 27,825 women being published in the journal Radiology found significant improvement in cancer detection with the ultrasound exams.
For example, he said, in women with fatty breasts - the least dense - a mammogram can catch 98 percent of cancers before they are large enough to be felt. Fatty tissue appears dark on the mammogram image while the tumor is white.
But as tissue density increases it also appears white, making it harder to differentiate a tumor, Kolb explained.
In women with the most dense breasts, a mammogram only detected 48 percent of the smallest tumors, he said. Combining mammograms and ultrasound exams raised the detection rate to 94 percent, he said.
Dr. Jennifer Harvey of the University of Virginia said she sometimes recommends ultrasound in addition to mammograms for patients who are at high risk and whose breasts are extremely dense.
For women with very dense breasts the sensitivity of a mammogram is about 50 percent, she said. Because density does not affect ultrasound it can be a nice compliment to mammography, she said.
But the patient still needs to have both tests done, said Harvey, who was not part of Kolb's research group.
She said it will be interesting to see if other investigators have findings similar to his.
Kolb said false positive rate in which ultrasound found something that needed to be checked with a biopsy, but turned out not to be cancer, was 2.5 percent.
Unfortunately, Kolb said, because ultrasound is not currently accepted practice for detecting breast cancer it is not covered by insurance, meaning an extra expense of up to $100 for the woman who wants the test. Harvey said the test can run up to $140.
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