Detecting, Diagnosing Breast Cancers

Tuesday, April 15, 2008; 4:00 AM

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MONDAY, April 14 (HealthDay News) -- New studies into breast cancer imaging techniques reinforce the importance of these procedures in detecting and treating tumors in the young and the elderly.

The findings, all expected to be presented during the American Roentgen Ray Society's annual meeting this week, in Washington, D.C., include:

• Evaluating palpable breast lesions by using mammography and sonography helps rule out cancers in most patients.
• MRIs are effective at showing how the blood flows to and from certain breast tumors, a critical fact in determining treatment planning and prognosis.
• An MRI given before initial surgical treatment resulted in 28 percent of breast cancer patients having their treatment changed.
• Women over age 70 can still benefit from mammograms even though some guidelines do not recommend the need for the exam.

Mammography and sonography

Researchers at Baystate Health in Springfield, Mass., showed that when mammography and sonography are combined, they are 98 percent effective in ruling out cancers in most patients.

In evaluating 414 palpable breast lesions using both imaging techniques, 118 lesions were correctly viewed as negative after three years of patient evaluation, which included 28 patients having biopsies, according to the study. Two other original negative findings, though, proved to be false negatives with malignancies later being confirmed.

The two false-negative lesions "became increasingly suspicious on clinical exam and later became apparent by imaging," study author Dr. Erica Tyler said in prepared statement. One false-negative occurred in a patient with heterogeneously dense tissue and was diagnosed more than six years after initial clinical discovery. The second false-negative lesion occurred in extremely dense tissue and was diagnosed almost seven years after initial discovery.

"Uncommonly, palpable malignancies may not be detectable on both mammography and sonography, and this combination of imaging doesn't rule out malignancy," Tyler said. "Also, based on our findings, long-term clinical and imaging follow-up of over five years may be needed to diagnose all palpable cancers, when the initial mammogram and sonogram are unrevealing," she said.