Breast cancer: Ultrasound better for some

For women ages 30-39 with symptoms of possible breast cancer, ultrasound is a superior diagnostic tool to mammography, U.S. researchers say. Dr. Constance Lehman, director of radiology at Seattle Cancer Care Alliance and professor and vice chair of radiology at the University of Washington, said the use of ultrasound in women ages 30-39 who have overt breast symptoms -- palpable lumps, localized pain and tissue thickening -- is common practice in Europe, where guidelines typically recommend ultrasound as the primary diagnostic imaging tool. The risk for malignancy among women in this age group is small, but real, at about 1.9 percent, Lehman said. The study, published in the American Journal of Roentgenology, found in the 1,208 cases examined, sensitivity for ultrasound was 95.7 percent compared to 60.9 percent for mammography -- ultrasound exams found 22 cancers versus 14 by mammography. The researchers identified all women 30-39, who presented for diagnostic breast imaging evaluation at Seattle Cancer Care Alliance from January 2002 to August 2006. "Imaging plays an important role in evaluating women with palpable breast lumps," Lehman said. "Most lumps are not cancer. Ultrasound and mammography help us separate women who need a biopsy from those who can safely be followed or reassured that the lump is benign. In women under age 40, ultrasound is better at evaluating breast lumps compared to mammography. Mammography is still our best tool for screening women 40 and older, but targeted ultrasound is our tool of choice in evaluating symptomatic women under 40."