Enhanced Cancer Screening Could Detect Early Cases in Women with Dense Breasts

Recent research indicates that those with dense breast tissue may gain from an additional round of cancer screening, as a significant trial uncovered tumors that were overlooked in standard mammograms.

In the UK, mammograms—an x-ray scan used for breast cancer screening—are provided for individuals aged 50 to 71. These scans look for white spots that indicate cancer presence. However, around 50% of women in this age range have dense breasts, characterized by a high amount of fibrous and glandular tissue, also appearing white on the scans. This similarity complicates tumor detection.

“The challenge with dense breasts is that cancers may go unnoticed until they grow significantly large, which negatively affects prognosis,” said Thomas Hervich, who wasn’t a part of the study at the Medical University of Vienna in Austria.

To determine whether additional screenings can help, Sarah Vinnicombe and her colleagues at the University of Dundee recruited over 6,000 women aged 50-70 from across the UK. Participants were randomly divided into three groups, each receiving extra screening through advanced x-ray methods such as MRI, ultrasound, or contrast-enhanced mammography.

In this extended screening phase, MRI and contrast-enhanced mammography together identified 85 small tumors—three times as many as detected by ultrasound. Twelve of these tumors were located in milk ducts, suggesting a lower likelihood of spreading beyond the breast. Conversely, the other 73 tumors were invasive, increasing the risk that cancer could migrate into surrounding breast tissue and beyond.

“Detecting these cancers is crucial. They typically grow over time, and finding them within three to four years can lead to larger sizes,” stated Hervich. “Some tumors are aggressive, so I believe supplemental screening could save lives.”

However, it’s uncertain if this will hold true. For instance, a 2021 trial on ovarian cancer screening revealed a decrease in cases but did not correlate with increased longevity. Additionally, some tumors detected may not be cancerous or aggressive. Thus, unnecessary screening could lead to undue anxiety and treatment.

The researchers plan to continue monitoring participants to assess whether supplementary screenings result in saved lives.