Breast oncologists can turn off the magnets during follow-ups

A University of Western Australia study has shown that ultrasound is a cost- and time-effective follow-up for women under 50 who’ve had an MRI screening for breast cancer.

Annual MRI screening for high-risk women under 50 has been in place in Australia since 2009. While the usefulness of ultrasound for breast MRI follow-ups has been established in the general population, few studies have investigated its effectiveness in asymptomatic—but at risk—young women. During the follow-up, the need for additional MRI is eliminated if the lesion is detected on a targeted ultrasound scan. Clinicians can move right from identifying a lesion to an ultrasound-guided biopsy, saving time and money.

The study sampled 139 women who underwent screening MRI, 30 of whom were recalled for follow-up examinations. During the follow-up, targeted ultrasound detected 75 percent of lesions, comparable to MRI studies by Kam et al and Sim et al. Using a technique called ultrasound of a quadrant, the targeted ultrasound is “less operator dependent, more reproducible, faster, and able to be performed by a radiologists who is not the MRI reporting radiologist,” wrote lead author Prasant Peter, Department of Radiology, Sir Charles Gairdner Hospital, Perth, Austrialia, and colleagues.

Ultrasound is cheaper when compared to CT or MRI imaging, costing about half as much according to an Italian study. However, MRI is still useful in some situations.

“MRI-guided biopsy must be considered for suspicious lesions, which are not detected on the targeted ultrasound as there is a definite, but low, risk for cancer," the authors wrote.