Current Status of Supplemental Screening in Dense Breasts
Mené auprès de 3 231 patientes présentant une densité mammaire élevée et ayant subi une mammographie qui n'a révélé aucune lésion cancéreuse (âge médian : 51 ans), cet essai évalue, du point de vue du taux de détection de cancer du sein et du nombre de résultats faussement positifs, l'intéret d'ajouter une tomosynthèse ou une échographie à une mammographie
Currently, 24 American states have laws requiring that women receive some level of notification about breast density with their mammography results. Dense breast tissue can hide cancer on mammography, especially when the cancer lacks calcifications, resulting in delayed diagnosis and worse outcomes. Moreover, dense breast tissue is an independent risk factor for developing breast cancer. Particularly in dense (heterogeneously dense or extremely dense) breasts, a negative result on mammography does not reliably exclude the presence of cancer. Advocates pushed for legislation requiring that notification of breast density be given with mammography results so that women with dense breasts would be aware of the implications, and could pursue supplemental screening beyond mammography. The most widely available supplemental screening options for women with dense breasts are ultrasound (US) and tomosynthesis (three-dimensional [3D] mammography), but there has been a lack of information to guide the decision to have one or the other versus both. Preliminary results from the Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts (ASTOUND) trial, an important study of adjunct screening with US and tomosynthesis (3D mammography) in women with dense breasts, are presented in the accompanying article in Journal of Clinical Oncology.
Journal of Clinical Oncology , éditorial en libre accès, 2016