New, supplemental scan can help detect breast cancer missed on mammograms

A new breast cancer scan. Already it’s catching cancers missed on mammograms. It’s called ABUS and doctors say it’s giving them the gift they need to diagnose patients early when their cancer is more treatable.

Dr Georgia Giakoumis Spear, radiologist, NorthShore University HealthSystem: “Here on these images there’s a very small little dark area that you can see. This is where I was able to find Patty’s malignancy, Patty’s cancer.”

But in the exact same area on the mammogram image – nothing. Just the white tissue. That’s because the patient, Patty Beyer, has dense breast tissue. About half of all women share the same trait.

Dr Spear: “So the area of concern we saw on the automated screening ultrasound you really cannot see this on the mammogram. It is right in this area. What you can see here you see quite a bit of white tissue. This white tissue makes up Patty’s fibroglandular or dense tissue. This is what we call dense tissue as opposed to fatty tissue, which is very light gray. Since this white tissue is so present in her breast tissue and it makes up such a large portion of the breast, we can miss malignancies because cancer can appear as white on a mammogram.”

That’s why NorthShore University HealthSystem radiologist Dr Georgia Spear added automated breast ultrasound as a supplemental screening tool.

Dr Spear: “We have a special probe that’s actually very large as you can see. We place this on the patient as she is lying flat on her back. It’s much larger so your field of view is much larger, and you’re able to cover the entire breast tissue.”

Just like traditional ultrasound, the images help doctors delineate between water-filled cysts and solid lesions. But in this case, the probe is not operated manually. It mechanically rolls over tissue more thoroughly, covering the entire breast. In Patty’s case, it captured a small but suspicious mass.

Dr Spear: “In her case her malignancy was in the outer aspect of the breast right in here in this dense tissue, which we would have never seen on a mammogram.”

Patty Beyer, breast cancer patient: “When I called for my mammogram I also asked for an ultrasound.”

Not every patient knows she has dense breast tissue, but Patty’s sister did and encouraged her to push for additional screening.

Patty Beyer: “You go every year and try to do all the things that will make you healthy, and it was devastating and very disturbing because no one had educated me about dense breast tissue and what it means. My doctor never had a conversation with me about it so if I hadn’t had the ultrasound as my sister encouraged me to do, I’d still have cancer today.”

The technology has been in use for about a year at NorthShore, and already it’s making a big difference.

Dr Spear: “What we found is we found six cancers in 500 patients. These patients had negative screening mammograms.”

Patty Beyer: “Women need to be their own advocate and really find out your breast tissue type. It’s not something everybody knows about. I’m so grateful.”

Dr. Spear is as well and that’s why she is so thrilled to continue her study of ABUS. It may be covered by insurance depending on the carrier otherwise it is $400 to $500 out of pocket. At this point not many places have automated breast ultrasound – less than 100 around the country. But if you have dense breast tissue, know the screening tools to ask for.