New screening technology screens dense breasts

4:22 PM, Jun 10, 2012   |    comments
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Tampa, FL -- Breast cancer can sometimes be difficult to spot especially in women with dense breast tissue which is about 40 percent of the population. But a new piece of technology called sonocine can help. It allows doctors to see through that dense tissue and it records the entire exam on video.

An Atlanta-area doctor that uses this test says in the past, mammograms would miss about 50 to 60 percent of cancers in women with dense breasts. The new procedure costs $2500 without insurance.

We asked Dr. Chris Flowers, Director of Breast Imaging and Research at Moffitt to weigh in on whether women should seek out this technology:
"Women who have dense breasts on mammography have an increased risk of breast cancer. As mammography cannot find all cancers in dense breast tissue, some states (Texas and Connecticut) have established laws that mandate the provision of information for women found to have dense breasts, and recommend considering adding ultrasound or MRI screening to mammography to improve the cancer detection rate.

Some centers have been offering a type of bilateral breast screening with conventional ultrasound, but this is very time consuming and relies on the skill of the person doing the exam. As a result new devices are being developed to automate the exam and make it more accurate.

SonoCine is one particular brand of device for automated breast ultrasound, recommended for some women who may have dense breast tissue. The best term to use for this is "automated breast ultrasound" as it does not rely on the human factor, unlike current ultrasound technology. I personally do not think that this is the best version of the technology, but I know colleagues who use it and like it.

There are downsides to adding ultrasound to mammography, in that your chances of a false positive examination become extremely problematic, and biopsy may be required to follow up the incidental findings. It should only be done in an expert center. These false positive examinations are much more common than with mammography screening and should be considered as a bad side effect of adding another screening test.

The American College of Radiology has put out a statement warning about subsequent patient anxiety when given news about  breast density: "For women with dense breasts, receipt of breast density information may create undue anxiety about their risk and worry that mammography may have missed a breast cancer."

There is also no evidence that including ultrasound as a screening tool increases the number of lives saved.

The final issue is one of reimbursement, in that the exam is not adequately covered by the current codes, and it may be that patients will have to pay a charge for this scan, which would potentially cause an unfortunate disparity between women who can afford to pay for the additional screening exam and those who cannot.

Moffitt Cancer Center is seeking to raise funds to purchase a similar machine to use for its high-risk population, but its use requires further research before it's available for the general population, as we seek to minimize the harms of introducing new technology with a high false positive chance for biopsy."