Aiding in early detection
While mammographic screening remains the 'gold standard' for early detection of breast cancer, ultrasound is conducted as a double check and is especially important with patients with dense breasts, which is estimated internationally at 40%.
On a mammogram, dense tissue looks white and since masses or lumps also appear white on a mammogram, the dense breast tissue may mask a suspicious lump. It is for this reason that there is a global movement towards utilising ABUS technology in addition to mammography to ensure the best possibility of early detection.
"Due to the younger age structure of our population, about 90% of our patients have dense breasts on mammography. While our cancer detection rate in these breasts with mammography and hand-held ultrasound is comparable to the best screening programs worldwide, ABUS has been shown to significantly improve the detection rate for small cancers in these breasts," says Professor Justus Apffelstaedt, Associate Professor at the University of Stellenbosch and Head of the Breast Cancer Unit at Tygerberg Hospital.
In traditional, hand-held ultrasound, the probe is held by hand and advanced over the breast while the sonographer checks the image - only if the sonographer feels that it should be done, is an image recorded.
With Automated Breast Ultrasound, the probe is moved automatically at a constant speed over the breast while images are constantly recorded. Post-acquisition image manipulation is possible with ABUS - such as three-dimensional reconstructions and rotations. Checking of images of the entire breast can be performed at a later stage as image acquisition and interpretations are separated, enabling review of images by several readers. These features greatly enhance the detection of small lesions especially in dense breasts.
"As the technology is still very expensive, ABUS is likely to remain in the arena of specialised private breast health practices for now, but the hope is that the technology price will decrease in time, making it more accessible to all healthcare services," concludes Apffelstaedt.
