Filling the Gap with Supplemental Screening
In the first screening round, 7 of 2,978 participants (2.4 per 1,000 screened) were diagnosed with node-positive cancers. DBT alone detected 4 of 7 (57%), and DBT plus MBI detected 7 of 7 (100%).
In Year 2, 6 of 2,590 participants (2.3 per 1,000 screened) had node-positive cancers. DBT alone detected 1 of 6 (16%) and DBT plus MBI detected 4 of 6 (67%). Neither modality detected 2 of the 6 node-positive cancers (33%).
“Someone who’s having their routine annual screen every year should not be diagnosed with advanced breast cancer,” Dr. Hruska said. “That’s just unacceptable. With a supplemental screening every few years, we hope to find cancers earlier and see the diagnosis of advanced cancer go way down.”
Dr. Hruska said one of the strengths of the Density MATTERS trial was the mix of academic medical centers and community hospitals involved. Participating centers also included MD Anderson Cancer Center, Henry Ford Health System, ProMedica Breast Care (regional practice in Ohio), and a Mayo Clinic Health System site in La Crosse, Wisconsin.
“The enrollment of 12% minority patients extends the generalizability of our findings,” she said.
She said the trial results provide important data for healthcare institutions assessing the best modality for supplemental breast screening.
“I don’t want to discourage anyone from getting a mammogram, because they absolutely should,” Dr. Hruska said. “However, DBT doesn’t find all cancers, and women need to understand its limitations and consider how supplemental screening can fill the gap.”
According to Dr. Hruska, MBI is considered safe for routine screening, is well-tolerated by patients and is relatively inexpensive.
“MBI uses a well-established radiotracer that’s been used in cardiac imaging for a really long time,” she said. “It has fewer risks than other modalities and no contrast reactions. If a woman has a choice of modalities, it’s important that she understands the benefits and risks of each and be involved in the decision-making.”
For More Information
Access the Radiology study, “Molecular Breast Imaging and Digital Breast Tomosynthesis for Dense Breast Screening: The Density MATTERS Trial,” and accompanying editorial, “Molecular Breast Imaging with Digital Breast Tomosynthesis for Dense Breast Supplemental Screening.”
Read previous RSNA News stories about breast imaging: