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A New Age of Detection: The Whole Breast Ultrasound

Tuesday, December 27, 2016 12:20 PM

Dense breast tissue has become a more common topic of discussion, and has challenged specialists like Dr. Georgia Spear, Director of NorthShore’s Clinical Breast MRI Program, to utilize more advanced technology for more accurate screenings. Dr. Spear recently did a chat on NorthShore’s new whole breast ultrasound technology, which provides more accurate screenings for women with dense breast tissue. She answers more common questions about this new technology below:

How does a patient know if they have dense breast tissue?
Dense breast tissue is a term used by radiologists to describe the amount of fibroglandular breast tissue as compared to fatty tissue in the breast. At NorthShore University HealthSystem, your radiologist will interpret your mammogram and report your density on the radiology report. Knowing whether you have dense breast tissue is important because dense breast tissue can mask cancer from being detected on your mammogram. Furthermore, having dense breast tissue increases your risk for developing breast cancer.

If a patient has dense breast tissue, what are usually the next steps for screenings?
Talk to your doctor. Depending on your breast density and your personal risk factors for developing breast cancer, the Automated Breast Ultrasound (ABUS) may be recommended as a supplemental screening tool. Please remember, ABUS does NOT replace mammography for breast cancer screening. Together, the mammogram and the ABUS exam help detect more breast cancers and also help reduce the chances that you will be called back for additional imaging based on your breast cancer screening exams.

Can you tell us a little about ABUS? How is it different from other breast imaging technology?
Automated Breast Ultrasound is an FDA-approved, non-invasive, painless ultrasound procedure that scans the breast tissue using sound wave technology. The images are post-processed and allow our physicians (radiologists) to view the breast tissue in 3D planes. The imaging allows for thorough visualization of the breast tissue, overcoming overlapping of tissue. Risk is essential in how we stratify our patients and determinate what imaging studies are right for them. Breast MRI is utilized in the screening setting for women who have a greater than or equal to 20% lifetime risk for developing breast cancer, but the guidelines do not support annual MRI with mammography in women with a lifetime risk of less than 20% because the benefits of the screening study do not outweigh the risks. If you have a strong family history of breast or ovarian cancer, I would recommend a consultation with the High Risk Clinic at NorthShore University HealthSystem Evanston Hospital. Your personal risk will be assessed and the proper screening recommendations will be made.

What are the benefits of ABUS for women with dense breast tissue?
Dense breast tissue limits our sensitivity for detecting breast cancer with mammography, the current gold standard for breast cancer screening. Dense breast tissue also raises a person’s risk for developing breast cancer. Up to 1/3 of breast cancers may be missed with mammographic screening alone. ABUS is a supplemental ultrasound screening tool that has been shown to increase cancer detection and decrease the chance that you will be called back from your screening mammogram examination.

If a woman has dense breast tissue and requires ABUS, does that mean she can skip her yearly mammogram?
This is a great question. No, the mammogram is NOT to be replaced by ABUS. Some early breast cancers present with breast calcifications can only be detected by mammography. Mammography and ABUS are complementary examinations and ABUS is recommended as a supplemental screening tool in women with dense breast tissue. The two examinations together help detect more breast cancers and also help reduce the chances that you may be called back for additional imaging based on your breast cancer screening exams.

Is the whole breast ultrasound typically covered by insurance?
Insurance coverage is variable. We urge you to check with your provider for coverage of the ABUS (Automated Breast Ultrasound) examination. If coverage of the ABUS examination is not provided, out-of-pocket costs are estimated at $400-$500.