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Tracking Tumors With Ultrasound
Mammography has already established itself as an important tool in tracking suspicious masses and thus preventing unnecessary biopsies. Physicians can use mammography
to follow a suspicious area’s progress and perform a biopsy only if it grows or shows other signs of being cancerous.
But what about ultrasound? It’s a question gaining importance as physicians increasingly turn to ultrasound in addition to mammography to screen women for breast cancer.
While ultrasound might help find masses that mammograms miss—especially in high-risk women or those with dense breasts—it has been unclear up to this point whether ultrasound can, like a mammogram, effectively follow the progress of a mass to prevent unnecessary biopsies. Should masses detected by ultrasound that aren’t visible on mammograms be biopsied? Or is ultrasound capable of tracking ever-smaller masses to see if a biopsy is truly necessary?
To find out, researchers at the University of California in San Francisco and their colleagues in Vienna, Austria, examined ultrasound records to observe the progress of 445 breast masses for an average of 3.3 years (Radiology, July). Three of the masses grew larger during that time. One of them was eventually diagnosed as cancer, and the other two were biopsied but determined to be noncancerous. That means that more than 99 percent of the masses were safely followed using ultrasound instead of biopsies, a rate that the authors described as “extremely high.”
The findings support the use of ultrasound to monitor breast masses that mammograms can’t detect, though future trials will be needed to prove the method’s safety and determine which women stand to benefit most.