In a new effort to improve early breast cancer detection and reduce false-positive exams in women with dense breasts, the American College of Radiology (ACR), the Breast Cancer Research Foundation (BCRF), and GE Healthcare are partnering to support the Contrast-Enhanced Mammography Imaging Screening Trial (CMIST). The planned trial, managed by the ACR Center for Research and Innovation, seeks to determine whether contrast-enhanced spectral mammography screening provides more accurate cancer detection than the combination of digital breast tomosynthesis and whole-breast ultrasonography in women with dense breasts.
Approximately 40% of women aged 40 and older have dense breasts, which can make detection of breast cancer more challenging with mammography alone. With wider adoption of digital breast tomosynthesis, and increased use of supplemental screening ultrasonography due to breast density notification laws, many women with dense breasts are screened each year with both digital breast tomosynthesis and whole-breast ultrasonography.
Contrast-enhanced spectral mammography combines mammography and vascular-based screening methods that may offer a more efficient screening approach. Contrast-enhanced spectral mammography highlights areas of unusual blood flow patterns in a simple and quick procedure. Early studies of contrast-enhanced spectral mammography in screening women with dense breasts have shown that it has the potential to increase the breast cancer detection rate by 70% to 80% compared with conventional mammography.1
Expected to launch in the spring of 2020, the paired-design multicenter trial will evaluate the performance of contrast-enhanced spectral mammography in screening women with mammographically dense breasts (Breast Imaging Reporting and Data System [BI-RADS] density categories C and D), between the ages of 40 and 75, at average-to-intermediate risk for breast cancer, compared with the combination of tomosynthesis and ultrasonography. ■
1. Sung JS, Lebron L, Keating D, et al: Performance of dual-energy contrast-enhanced digital mammography for screening women at increased risk of breast cancer. Radiology 293:81-88, 2019.