The Challenge of Dense Breasts

Women with increased breast density on mammograms (this includes approximately half of screening age women (2)) are four to five times more likely to get breast cancer than women with normal breast density (3). Furthermore, mammograms alone miss over 40% of cancers in women with dense breasts, which is more than twice compared with women with non-dense (or fatty) breasts (4). Therefore women with dense breast have two disadvantages. First, they have a higher chance of having breast cancer; and second, if and when they have breast cancer, they have a lower chance of it being detected early.

When ultrasound was added to the first screening mammogram, it can increase the number of detected cancers by more than 70% (1,5).  Almost all of additionally detected cancers by ultrasound found in women with dense breasts are small (less than 11 mm) invasive cancers without evidence of spread to the lymph nodes (5). These small lesions represent cancers which can advance faster to a less favorable stage, but are found at a stage where they have a very good chance to be cured.

Breast ultrasound screening with the existing hand held equipment is significantly limited due to operator’s dependency, lack of qualified personnel and relatively long exam times. The new automated  ultrasound systems on the market, designed to reduce operator’s dependency,  shift the burden of time from the images acquisition to the physicians, who have to interpret hundreds or thousands of images instead of tens of images selected during scanning. This is a major factor that is limiting the adoption of automated breast ultrasound scanners.  

Precise breast tissue mapping is limited with the existing hand held and automated breast ultrasound systems.

Metritrack’s automated mapping technology is designed to deliver unprecedented precision and may reduce exam time due to the elimination of multiple operator dependent steps; resulting in higher quality and efficiency when compared to current whole breast ultrasound exam techniques.

The significance of breast density awareness is leading to policy shifts in the US, resulting in legislative changes that are favorable for ultrasound testing (i.e., dense breast legislation). More information on this topic can be found at the following resources.

1.    http://breastscreening.cancer.gov/statistics/performance/screening/2009/rate_time.html
2.    http://www.breastdensity.info/
3.    http://ww5.komen.org/BreastCancer/HighBreastDensityonMammogram.html
4.    Mandelson et al, J Natl Cancer Inst 2000; 92:1081–1087
5.    http://www.sbi-online.org/RESOURCES/Breast_Sonography.aspx