Study shows ultrasounds better than mammograms for young women

A new study led by Dr. Constance Lehman, director of imaging at the Seattle Cancer Care Alliance (SCCA) and vice chair of radiology at the UW, found that ultrasounds are a more effective way of diagnosing localized symptoms of breast cancer in women younger than 40.

There are two kinds of lumps found in breast tissue, cancerous and noncancerous. Dr. Wendy DeMartini, associate professor of radiology, said it can be difficult to discern between the cancerous cells and young breast tissue, both of which appear white on mammograms. This occurs because young breast tissue is denser than the surrounding tissue, much like that of the dense cancerous tumors.

“Right now the [American College of Radiology] guidelines suggest to use mammography as the first imaging tool in women ages 30 to 39,” Lehman said. “We think that our research — which is the largest to date and the only study in the last decade in this patient population — will help guide the American College of Radiology to change those recommendations so women instead can have an ultrasound and, only when needed, a mammogram.”

Both researchers said not much resistance has been seen since the release of the study. Not only is an ultrasound less radioactive and more comfortable to the patient, but it’s also less expensive.

“[It was an] important clinical question, [and] we felt that we had the resources to look at our data and try to come up with some answers or information about the performance,” DeMartini said.

Ultrasounds have been used as a secondary diagnosis option for several years, but this research is the first to show the effectiveness of ultrasounds using empirical data over mammography for younger women.

There are other reasons to forego the mammogram for younger patients. One reason is that mammograms use radiation, and DeMartini said it’s a good idea to reduce exposure to radiation whenever possible.

DeMartini said another reason to use an ultrasound is for the comfort level of the patient. Ultrasounds use sound waves to penetrate the tissue, whereas mammograms apply extreme pressure and also use the radiation to see through the tissues.

According to Lehman, many doctors had already used ultrasounds to diagnose localized symptoms of breast cancer.
For annual visits, Lehman said a mammogram is still the recommended procedure.

Mammograms are still instrumental in diagnosing cancers in women over 40. The researchers said there are advantages to using either method in the detection of breast cancer.

Reach reporter Deanna Isaacs at news@dailyuw.com. Twitter: @DeeLiteraryOne