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Targeted breast ultrasound can reduce biopsies for young women

SCCA finds noninvasive screening better for evaluating anomalies in women under 40

Dec. 14, 2009
Dr. Connie Lehman

Dr. Connie Lehman, Seattle Cancer Care Alliance

Targeted breast ultrasound of suspicious areas of the breast is a safe, reliable and cost-effective alternative to invasive biopsies for women under age 40, according to two Seattle Cancer Care Alliance studies.

"By performing high-quality breast ultrasound, we can reduce the number of expensive and avoidable invasive diagnostic procedures in young women," said senior author Dr. Connie Lehman, the SCCA's director of Breast Imaging and a professor and vice chair of radiology at the University of Washington. "We don't want to be overly aggressive with this population."

The studies, which were presented at this month's annual Radiological Society of North America meeting, used targeted ultrasound to distinguish between potentially cancerous masses and benign findings in young women who had detected breast lumps or other specific areas of concern in their breasts. The first study included more than 1,100 ultrasound examinations of women under age 30, while the second included more than 1,500 ultrasound examinations of women ages 30 to 39.

Across both studies, all instances of cancer at the site of the clinical concern were positively identified through targeted ultrasound. In addition, all negative ultrasound findings correctly identified benign changes in the breast.

The incidence of malignancy among women in their 30s was 2 percent. The incidence of malignancy among women younger than 30 was 0.4 percent.

"Surgical excision or needle biopsy of tissue can be painful, expensive and frequently unnecessary in these age groups, which have very low rates of malignancies," Lehman said. "In most cases, monitoring with targeted ultrasound is a very safe alternative."

Members of the SCCA's Breast Imaging program coauthored the studies, including Sue Peacock and Drs. Vilert Loving, Wendy DeMartini, Peter Eby and Robert Gutierrez for under-30 study, and Drs. Michael Portillo, DeMartini, Eby, Gutierrez and Franklin Liu for the study addressing women age 30-39.

[Adapted from a Radiological Society of North America news release.]

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