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To the Editor: Dr Berg and colleagues¹ provide evidence on the detection of breast cancer using ultrasound as adjunct screening to mammography, using a risk-based selection of participants, many of whom had a personal history of breast cancer. Although the sensitivity of 50% reported for mammography is within the range of sensitivities reported in screening dense breast tissue, this encompassed a broader distribution of breast tissue density categories (including the less dense category D2) than did other studies of ultrasound screening in women with dense breasts.^2-3 The incremental cancer detection with ultrasound is important but should be interpreted relative to the moderate sensitivity of mammography reported in this population of women. A recent study of ultrasound screening in women with dense (D3-D4) breasts used blinded review of mammograms from women with ultrasound-detected cancers that had been previously reported as negative; 8 of 33 had abnormalities on mammography correlating with ultrasound-detected . . . [Full Text of this Article]

Nehmat Houssami, MBBS, FAFPHM, PhD
nehmath@med.usyd.edu.au
School of Public Health
University of Sydney
Sydney, Australia

Stefano Ciatto, MD, PhD
Centro per lo Studio e la Prevenzione Oncologica
Florence, Italy

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