One of the highest-profile scientific presentations at RSNA this year detailed how targeted breast ultrasound can reduce biopsies for women under 40.

DOTmed met up with senior author Dr. Connie Lehman, professor and vice-chair of radiology at the University of Washington and director of imaging at the Seattle Cancer Care Alliance, to learn more about the studies involved and to get her perspective on current and proposed changes for mammography standards in the U.S.

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Study background and methodology

Researchers conducted two separate studies over two years' time at the University of Washington and Seattle Cancer Care Alliance. The studies involved more than 1,800 women who had "focal" or localized signs of a mass in the breast. This research was meant to investigate ultrasound as an alternative to invasive biopsies for distinguishing benign and malignant breast tumors.

In the first study, more than 1,000 women under 30 had ultrasounds to determine the nature of lumps found during either self or clinical examination. The second study included more than 1,500 women 30 to 39 who were similarly found to have breast abnormalities. Of women in the older group, 2 percent of masses were found to be malignant and all benign changes in the breast were positively identified by ultrasound. The only malignancy that went undiagnosed by ultrasound was a lesion outside of the targeted area being examined, but the cancer was picked up by full-breast mammography.

Dr. Lehman remarked that it was important that malignancies are caught as early as possible when there is the greatest chance for a cure. She also remarked that malignancy was very rare in women under 30. In fact, incidence of cancer in the study of women under 30 was .04 percent. The findings indicated that ultrasound is an effective tool for keeping track of suspicious lumps and for preventing unnecessary surgeries and biopsies in younger women.