Targeted ultrasound scores high marks as mammography alternative for breastfeeding women

Targeted breast ultrasound can serve as a solid alternative to mammography in breastfeeding women with palpable masses, imaging researchers advised Tuesday.

Women are increasingly pushing childbirth into their 30s and 40s, and cases of pregnancy-associated breast cancer are increasing, too. US is the recommended modality for detecting the disease in such instances, but scientists have conducted little research on the effectiveness of the practice. To close the knowledge gap, Maggie Chung, MD, and co-authors analyzed data from 167 symptomatic, breastfeeding women—at an average age of 35—who underwent targeted US. Comparing up against mammography, ultrasound scored high marks, University of California, San Francisco, experts wrote in Radiology

“Our findings support targeted US as the primary imaging modality for the evaluation of palpable breast findings in lactating women, including those of advanced maternal age,” Chung, with the Department of Radiology and Biomedical Imaging at UCSF, and colleagues wrote Sept. 1.

All told, targeted ultrasound of lactating women logged a 100% sensitivity rate, depicting all malignancies, and 70% specificity. Patients who underwent mammography along with US saw seven additional false-positive findings with no additional cancer diagnoses, the team reported, and specificity dropped from 67% down to 61%.

In a corresponding editorial, Emory University professor and radiologist Mary Newell, MD, praised the study authors. She also urged peers to approach the imaging of lactating women who have a lump in their breast or axilla with “heightened clinical attentiveness.”

“We are increasingly recognizing that a tailored approach to imaging can answer clinical questions safely and accurately, and in many cases more efficiently, than an all-encompassing approach. Chung et al. added more tiles to the image,” wrote Newell, who also serves as associated editor for Radiology. “Future research can confirm whether this method is achievable in a variety of practice settings, can depict all types of breast cancer, and is safe as a stand-alone problem-solving tool in women age 40 years and older.”

You can read the full study here and the corresponding analysis here.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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