Mammograms may be missing some breast cancers, study shows

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Additional screening techniques can detect more cases of breast cancer in some women, researchers say standard breast checks may not be spotting a number of cancers, new research suggests.

Mammograms, which are offered to women aged 50 to 70 through the NHS, may not be sensitive enough, researchers said.


Using an additional screening technique can detect cancers that would have been missed using the standard screening programme, they found.

The study, presented to the European Breast Cancer Conference in Amsterdam and published in the Journal of Clinical Oncology, found that additional tests can pick up more cases of cancer among women with dense breasts.

Women who are deemed to have “high breast density” are at a significantly higher risk of developing breast cancer than others.

Researchers from Australia and Italy analysed 3,231 women with dense breasts whose mammograms did not detect breast cancer.

Experts say there may be up to 700,000 women in the UK with a high breast density that puts them at increased risk of developing breast cancer.


They found that giving ultrasound and a type of 3D check called tomosynthesis spotted an extra 24 breast cancers that would otherwise have been missed.

Nehmat Houssami, professor of public health at the University of Sydney, told delegates: “These findings will have immediate implications both for screening practice and for guiding new research in dense breasts.

“These results mean that tomosynthesis detected an additional four breast cancers per 1,000 women screened and ultrasound detected an additional seven breast cancers per 1,000.”

Houssami added: “In this study we are comparing two additional tests to see if they can do better than standard mammograms in finding cancer in women with dense breasts; we have found that ultrasound does better than tomosynthesis, but ultrasound is a separate test, it is time-consuming and, in less experienced hands, it can lead to a lot of false alarms.

“However, tomosynthesis, which is a form of refined mammography, can be carried out as part of the standard 2D mammogram screen, or even instead of it.

“Given that tomosynthesis detected more than 50% of the additional breast cancers in these women, the implications are that it has the potential to be the primary mammography screening method without the need for an extra screening procedure.”

Commenting on the study, Delyth Morgan, chief executive of the charity Breast Cancer Now, said: “We know that mammography is less effective at detecting breast cancer in women with dense breasts and this new evidence reinforces the urgent need to consider how these women can be best served by the NHS breast screening programme.


“Over 700,000 women in the UK are estimated to have high breast density, putting them at an increased risk of breast cancer and making it more difficult for standard mammography to detect abnormalities,” Lady Morgan added.

“That said, there are significant risks involved with tomosynthesis and ultrasound techniques that must be considered, particularly around false positives, as well as the cost, resource and training that would be required.

“We hope the emerging studies will highlight the best way for women to be given more information about their breast density and reinvigorate debate around how we can ensure these women have the best chance of having cancers found early,” Morgan said.

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