Ultrasound Alongside with Mammogram in Women with Physically Dense Breast

Fadak S.  Alshayookh; Howayda M.  Ahmed; Ibrahim A.  Awad; Saddig D.  Jastaniah

doi:10.4236/abcr.2014.33013

Fadak S. Alshayookh, Howayda M. Ahmed, Ibrahim A. Awad, Saddig D. Jastaniah

Abstract: We report usefulness of ultrasound used as an adjunct diagnostic tool to mammogram in routine annual checkup for women breasts of certain ages and breast mass. The purpose of breast imaging is to detect areas of tissue distortion and breast cancers. A mammogram is the common diagnostic imaging modality used to find breast diseases but sometimes the mammogram might not give the doctor enough information especially in women with dense breasts. As a result, the patient may be asked to undergo ultrasound or magnetic resonance imaging as a better mean of judgment to the case. Because ultrasound is widely used, simple and safe to patients we were encouraged to emphasis on exploring its role adjunct to mammogram. A retrospective observation study was done at the diagnostic radiology department at King Abdulaziz University Hospital (KAUH) in the period from January 2012 to June 2012; we covered all women with dense breasts in mammography and ultrasound units. The study group was 40 patients. All patients were imaged with both mammography and ultrasound. The statistical measures of accuracy, sensitivity and specificity were calculated using the SPSS program. The results we obtained suggest that age and the physical density of breast potentially affect mammogram images of women with 41 years or smaller with sensitivity 66% and specificity 68%. Therefore, we recommend using ultrasound alongside the mammogram in women with dense breast for better diagnosis of small cancers that were not identified on mammography or clinical breast examination alone.

Keywords: Ultrasound, Mammogram, Dense Breasts, Women Breasts

Cite this paper: Alshayookh, F. , Ahmed, H. , Awad, I. and Jastaniah, S. (2014) Ultrasound Alongside with Mammogram in Women with Physically Dense Breast. Advances in Breast Cancer Research, 3, 88-95. doi: 10.4236/abcr.2014.33013.

References

[1] Birdwell, R.L., Ikeda, D.M., O’Shaughnessy, K.F. and Sickles, E.A. (2001) Mammographic Characteristics of 115 Missed Cancers Later Detected with Screening Mammography and the Potential Utility of Computer-Aided Detection. Radiology, 219, 192-202.
http://dx.doi.org/10.1148/radiology.219.1.r01ap16192

[2] Pinsky, R.W. and Helvie, M.A. (2010) Mammographic Breast Density: Effect on Imaging and Breast Cancer Risk. Journal of the National Comprehensive Cancer Network, 8, 1157-1164.

[3] Wirth, W., Nikitenko, D. and Lyon, J. (2005) Segmentation of Breast Region in Mammograms Using a Rule-Based Fuzzy Reasoning Algorithm. ICGST Graphics, Vision and Image Processing Journal, 5, 45-54.

[4] Asselin-Labat, M.L., Vaillant, F., Sheridan, J.M., Pal, B., Wu, D., Simpson, E.R., Yasuda, H., Smyth, G.K., Martin, T.J., Lindeman, G.J. and Visvader, J.E. (2010) Control of Mammary Stem Cell Function by Steroid Hormone Signalling. Nature, 465, 798-802. http://dx.doi.org/10.1038/nature09027

[5] Baker, S., Wall, M. and Bloomfield, A. (2005) Breast Cancer Screening for Women Aged 40-49 Years—What Does the Evidence Mean for New Zealand? The New Zealand Medical Journal, 118, 1-8.

[6] Carney, P.A., Miglioretti, D.L., Yankaskas, B.C., Kerlikowske, K., Rosenberg, R., Rutter, C.M., Geller, B.M., Abraham, L.A., Dignan, M., Cutter, G. and Ballard-Barbash, R. (2003) Individual and Combined Effects of Age, Breast Density, and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography. Annals of Intern Medicine, 138, 168-175. http://dx.doi.org/10.7326/0003-4819-138-3-200302040-00008

[7] Dummin, L.J., Cox, M. and Plant, L. (2007) Prediction of Breast Tumor Size by Mammography and Sonography—A Breast Screen Experience. The Breast Journal, 16, 38-46.
http://dx.doi.org/10.1016/j.breast.2006.04.003

[8] David, N., Jackie, S., Butler, L. and Lewis, R. (2006) Hole’s Human Anatomy and Physiology. 11th Edition, McGraw Hill Higher Education, 880-881.

[9] Liberman, L., Feng, T.L., Dershaw, D.D., Morris, E.A. and Abramson, A.F. (1998) US-Guided Core Breast Biopsy: Use and Cost-Effectiveness. Radiology, 208, 717-723.

[10] Warner, E., Plewes, D.B., Hill, K.A., Causer, P.A., Zubovits, J.T., Jong, R.A., Cutara, M.R., DeBoer, G., Yaffe, M.J, Messner, S.J., Meschino, W.S., Piron, C.A. and Narod, S.A. (2004) Surveillance of BRCA1 and BRCA2 Mutation Carriers with Magnetic Resonance Imaging, Ultrasound, Mammography, and Clinical Breast Examination. Journal of the American Medical Association, 292, 1317-1325.
http://dx.doi.org/10.1001/jama.292.11.1317

[11] Dempsey, P.J. (2004) The History of Breast Ultrasound. Journal of Ultrasound in Medicine, 23, 887-894.

[12] Berg, W.A., Gutierrez, L., NessAiver, M.S., Carter, B., Bhargavan, M., Lewis, R.S. and Ioffe, O.B. (2004) Diagnostic Accuracy of Mammography, Clinical Examination, US, and MR Imaging in Preoperative Assessment of Breast Cancer. Radiology, 233, 830-849.
http://dx.doi.org/10.1148/radiol.2333031484

[13] Kopans, D.B. (2008) Basic Physics and Doubts about Relationship between Mammographically Determined Tissue Density and Breast Cancer Risk. Radiology, 246, 348-353

[14] American College of Radiology (2003) Breast Imaging Reporting and Data System (BI-RADS). 4th Edition, American College of Radiology, Reston.

[15] Vacek, P.M. and Geller, B.M. (2004) A Prospective Study of Breast Cancer Risk Using Routine Mammographic Breast Density Measurements. Cancer Epidemiology, Biomarkers Prevention, 13, 715-722.

[16] Barlow, W.E., White, E., Ballard-Barbash, R., Vacek, P.M., Titus-Ernstoff, L., Carney, P.A., Tice, J.A., Buist, D.S.M., Geller, B.M., Rosenberg, R., Yankaskas, B.C. and Kerlikowske, K. (2006) Prospective Breast Cancer Risk Prediction Model for Women Undergoing Screening Mammography. Journal of the National Cancer Institute, 98, 1204-1214. http://dx.doi.org/10.1093/jnci/djj331

[17] American Cancer Society (2009-2010) Breast Cancer Facts & Figures. American Cancer Society, Inc., Atlanta.

[18] Pisano, E.D., Hendrick, R.E., Yaffe, M.J., Baum, J.K., Acharyya, S., Cormack, J.B., et al. (2008) Diagnostic Accuracy of Digital Mammography versus Film Mammography: Exploratory Analysis of Selected Population Subgroups in DMIST. Radiology, 246, 376-383.
http://dx.doi.org/10.1148/radiol.2461070200

[19] Tabar, L., Chen, H.H.T., Yan, M.F.A., Tot, T., Tung, T.H., Chen, L.S., Chiu, Y.H., Duffy, S.W. and Smith, R.A. (2004) Mammographic Tumor Features Can Predict Long-Term Outcomes Reliably in Women with 1-14-mm Invasive Breast Carcinoma. Cancer, 101, 1745-1759. http://dx.doi.org/10.1002/cncr.20582

[20] Berg, W.A. (2007) Beyond Standard Mammographic Screening: Mammography at Age Extremes, Ultrasound, and MR Imaging. Radiologic Clinics of North America, 45, 895-906.
http://dx.doi.org/10.1016/j.rcl.2007.06.001

[21] Berg, W.A., Blume, J.D., Cormack, J.B., Mendelson, E.B., Lehrer, D., Bohm-Vélez, M., Pisano, E.D., Jong, R.A., et al. (2008) Combined Screening with Ultrasound and Mammography vs Mammography Alone in Women at Elevated Risk of Breast Cancer. JAMA, 299, 2151-2163.
http://dx.doi.org/10.1001/jama.299.18.2151

[22] Baker, J.A. and Soo, M.S. (2002) Breast Ultrasound: Assessment of Technical Quality and Image Interpretation. Radiology, 23, 229-238.

[23] Stavros, A.T., Thickman, D., Rapp, C.L., Dennis, M.A., Parker, S.H. and Sisney, G.A. (1995) Solid Breast Nodules: Use of Sonography to Distinguish between Benign and Malignant Lesions. Radiology, 196, 123-134.

[24] Benson, S.R., Blue, J., Judd, K. and Harman, J.E. (2004) Ultrasound Is Now Better than Mammography for the Detection of Invasive Breast Cancer. American Journal of Surgery, 188, 381-385.
http://dx.doi.org/10.1016/j.amjsurg.2004.06.032

[25] Boonjunwetwat, D., Chyutipraiwan, U., Sampatanukul, P. and Chatamra, K. (2007) Sensitivity of Mammography and Ultrasonography on Detecting Abnormal findIngs of Ductal Carcinoma in Situ. Journal of the Medical Association of Thailand, 90, 539-545.

[26] Malur, S., Wurdinger, S., Moritz, A., Michels, W. and Schneider, A. (2001) Comparison of Written Reports of Mammography, Sonography and Magnetic Resonance Mammography for Preoperative Evaluation of Breast Lesions, with Special Emphasis on Magnetic Resonance Mammography. Breast Cancer Research, 3, 55-60. http://dx.doi.org/10.1186/bcr271

[27] Houssami, N., Irwig, L., Simpson, J.M., McKessar, M., Blome, S. and Noakes, J. (2003) Sydney Breast Imaging Accuracy Study: Comparative Sensitivity and Specificity of Mammography and Sonography in Young Women with Symptoms. American Journal of Roentgenology, 180, 935-940.

[28] Flobbe, K., Nelemans, P.J., Kessels, A.G., Beets, G.L., von Mevenfeldt, M.F. and van Engelshoven, J.M. (2002) The Role of Ultrasonography as an Adjunct to Mammography in the Detection of Breast Cancer: A Systematic Review. European Journal of Cancer, 38, 1044-1050.
http://dx.doi.org/10.1016/S0959-8049(01)00388-4

[29] Robinson, M. and Offit, K. (2007) Management of an Inherited Predisposition to Breast Cancer. New England Journal of Medicine, 357, 154-162. http://dx.doi.org/10.1056/NEJMcp071286