Lee JM, et al. - Researchers assessed significantly higher short-interval follow-up and biopsy recommendation rates with screening mammography plus same-day ultrasonography vs mammography alone among females with breast cancer risk ranging from low to very high. Although, they noticed no significant improvement in either cancer detection or reduction in interval cancer rates.

Methods

• In this observational cohort study, prospectively collected data on screening mammography with vs without same-day breast ultrasonography was provided by 2 Breast Cancer Surveillance Consortium registries from January 1, 2000, to December 31, 2013.
• They recorded the dates of analysis ie, March 2014 to December 2018.
• They propensity score matched (1:5) 6081 screening mammography plus same-day screening ultrasonography examinations in 3386 females to 30,062 screening mammograms without screening ultrasonography in 15,176 females from a sample of 113,293 mammograms.
• They included a personal history of breast cancer and self-reported breast symptoms under the exclusion criteria.
• Exposures included screening mammography with vs without screening ultrasonography.
• Using log binomial regression, they estimated cancer detection rate and rates of interval cancer, false-positive biopsy recommendation, short-interval follow-up, and positive predictive value of biopsy recommendation and were compared.

Results

• They performed screening mammography with vs without ultrasonography examinations more frequently in females with dense breasts (74.3% [n=4317 of 5810] vs 35.9% [n=39,928 of 111,306] in the overall sample), in women whose age were less than 50 years (49.7% [n=3022 of 6081] vs 31.7% [n=16,897 of 112,462]), and in ladies with a family history of breast cancer (42.9% [n=2595 of 6055] vs 15.0% [n=16,897 of 112,462]).
• They observed that 53.6% (n=2889 of 5392) had low or average (<1.67%) risk while 21.4% (n=1154 of 5392) of screening ultrasonography examinations were performed in females with high or very high (≥2.50%) Breast Cancer Surveillance Consortium 5-year risk scores.
• They noted comparable cancer detection rate at 5.4 vs 5.5 per 1000 screens (adjusted relative risk [RR], 1.14; 95% CI, 0.76-1.68), as were interval cancer rates at 1.5 vs 1.9 per 1000 screens (RR, 0.67; 95% CI, 0.33-1.37) when mammography plus ultrasonography with mammography alone were compared.
• A significantly higher false-positive biopsy rate was recorded at 52.0 vs 22.2 per 1000 screens (RR, 2.23; 95% CI, 1.93-2.58), as was short-interval follow-up at 3.9% vs 1.1% (RR, 3.10; 95% CI, 2.60-3.70).
• They also observed significantly lower positive predictive value of biopsy recommendation at 9.5% vs 21.4% (RR, 0.50; 95% CI, 0.35-0.71).