The Society of Breast Imaging and Oxford University Press have recently launched the Journal of Breast Imaging (JBI), the first peer-reviewed journal to focus solely on breast imaging. The founding Editor-in-Chief is Jennifer Harvey (seen below left, © UVA) who is professor of radiology and medical imaging at the University of Virginia in Charlottesville. Among Dr Harvey’s own research interests is a focus on mammographic density and its influence on breast cancer risk, with the ultimate aim of developing guidelines to personalize screening for individual women.
Included among the first papers in JBI are: “Breast cancer screening in high-risk patients during pregnancy and breastfeeding”; “Optimizing the patient experience during breast biopsy”; “Personalized screening in the age of acceleration”; “Lesion localization using digital breast tomosynthesis”; and “Finding inspiration for the next generation of breast radiologists.” An article that caught the eye of Kate Madden Yee of AuntMinnie.com was a review contributed by Dr Stephen Feig of the University of California, Irvine and entitled “Evidence of benefit from mammography screening of average-risk women ages 40-49 years.”
Feig argued that as technology improves so will the benefits increase, stating: “Advances in mammography techniques and breast ultrasound may allow even better results in the future.” He wrote that screening guidelines should be based on epidemiologic data such as the incidence of breast cancer in the population. Referring to the literature, Feig pointed out that at age 40 women have a 1.4% likelihood of developing breast cancer over the following 10 years, while at age 50 that number increases to 2.4%. He felt these data supported the notion that breast cancer screening should begin at age 40, rather than at age 50 as recommended by the American College of Physicians.
Feig emphasized three points in his review. First, the benefits of mammography have been underestimated in randomized controlled trials and population-based screening studies. Second, the importance of screening younger women should not be diminished by advances in treatment. Third, the relative benefit for different screening intervals of women in their 40s has not been studied in a randomized trial. He therefore concluded: “Annual screening is preferable to less frequent screening, especially during the 40 to 50 decade. Advances in mammography equipment and additional screening ultrasound will allow greater detection sensitivity for younger women with dense breasts.”
Feig’s final point is particularly relevant for CapeRay with its dual-modality Aceso system that combines full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in the same platform (seen right), and has been specifically designed for early detection of cancer in dense breast tissue.