Breast cancer suspicion Complementary ultrasound examination can detect more tumors

Supplement mammography with ultrasound: detect up to 45 percent more tumors

Mammography is one of the most important methods for the early detection of breast cancer. According to experts, over 17,000 carcinomas could be detected within a year. However, experts now report that up to 45 percent more tumors can be diagnosed if ultrasound diagnosis is used in addition to the X-ray examination.

Cancer with the highest death rate

Breast cancer is the cancer with the highest death rate among women in Germany. Every year, around 17,000 people die from it and around 70,000 fall ill each year. According to the German Society of Senology (DGS), about 80 percent of ill women today can be successfully treated. Much depends on an early diagnosis. Since 2002, women in this country have the opportunity to participate in the mammography screening for free. In this special X-ray examination numerous cancers of the breast are detected early. However, if additional ultrasound examinations are performed, significantly more tumors can be diagnosed.

With breast x-ray, many so-called breast cancers can often not be clearly identified. However, if the ultrasound diagnosis is used in addition, up to 45 percent more tumors can be detected. (Image: Sven Bähren / fotolia.com)

It is often not possible to clearly identify breast cancer during X-ray examinations

In Germany, women between the ages of 50 and 69 can take part in the breast cancer prevention program free of charge. But only about every second goes to mammography screening.

Often women are afraid of the examination. In addition, it is known that the investigation provides no guarantee.

The problem is that with the X-ray examination of the breast - the most common diagnostic methods in this country - a large part of the so-called breast cancer can often not be clearly identified.

However, if ultrasound diagnostics are used as a supplement, up to 45 percent more invasive carcinomas can be detected, reports the German Society for Ultrasound in Medicine e.V. (DEGUM).

The experts therefore demand that ultrasound breast ultrasound should be used as standard in routine screening for the early detection of cancer.

Added value of ultrasound too little known

"The high added value of ultrasound for the early detection of cancer is far too little known," says DEGUM expert Professor. med. Joachim Hackelöer, who held professorships in gynecology and obstetrics at universities in Hamburg and Marburg.

For example, the medical service of the umbrella association of health insurances (MDS) recently classified the benefit of this investigation as unclear in an assessment procedure for several individual health services (IGeL services).

In the opinion of Hackelöer there is an urgent need for information against this background.

But why is the benefit of breast ultrasound really so great? "The female breast consists of a mammary gland tissue. Connective tissue and fat envelop this glandular tissue, "explains Hackelöer.

"The ultrasound examination of the breast shows the glandular and connective tissue with bright echoes, whereas carcinomas often show dark echoes."

According to the information, this creates an echo contrast that makes the diagnosis effective. In contrast, the chest X-ray - the so-called mammography - does not show such a clear contrast between the tumor and the rest of the glandular and connective tissue.

Here, the carcinomas are bright or white and can therefore be masked or hidden by the rest of the gland and connective tissue. This is especially the case in women with dense tissue - ie a high proportion of mammary tissue.

Women with dense breast tissue

According to DEGUM, these women should therefore urgently be examined by ultrasound - and that is numerous: according to the latest data, nearly half of women aged 50 and over have dense breast tissue.

"The problem is that breast density is not systematically recorded and communicated in the German Mammography Screening Program. However, women with extremely dense glandular tissue have a higher risk of developing breast cancer, "says Professor Dr. med. med. Alexander Mundinger, Chief Physician of the Breast Center Section Imaging and minimally invasive breast diagnostics of the Niels Stensen Clinics at the Franziskus-Hospital Harderberg in Georgsmarienhütte.

At the same time, the risk of masking breast cancer is highest in these patients. "But even for them, an X-ray examination is only recommended and financed for the early detection of breast cancer in Germany every two years. That needs to change urgently. "

In order to discover more breast cancer tumors in the future, the DEGUM experts are calling for a new concept: "We urgently need a risk-adapted, optimized screening program in Germany. In this case mammography should be supplemented by ultrasound diagnostics of the breast ", says Hackelöer.

"In addition, the early detection must be carried out very individualized." Ideal, it would be in the opinion of experts, if the ultrasound and X-ray examination - depending on the density level of the breast - in women from the 40th Age about once a year would be applied standardized.

These examinations should preferably be carried out by DEGUM-certified gynecologists and radiologists. According to the ultrasound experts, the DEGUM concept should already be integrated into the screening training of prospective physicians - so that a high quality ultrasound can best be guaranteed. (Ad)