Enhanced Imaging Methods Detect Earliest Breast Cancers in Women with Dense Breasts

Recent research highlights that supplementary imaging techniques can significantly improve the detection of early-stage breast cancers in women with dense breast tissue, especially when mammograms show negative results. Dense breasts, which contain higher amounts of fibrous and glandular tissue and less fatty tissue, are known to mask tumors on traditional X-ray mammograms, leading to lower sensitivity in cancer detection. This has prompted the investigation of more effective imaging modalities.

A comprehensive Phase III randomized control trial, published in The Lancet, examined over 9,000 women aged 50–70 years in the UK who had dense breasts and received negative mammogram results. Participants were assigned to various additional imaging strategies, including MRI, contrast-enhanced mammography, and ultrasound. The study found that MRI and contrast mammography identified approximately 1.7% to 1.9% of cancers, which were not detectable through standard mammography, whereas ultrasound detected only about 0.4%. Notably, the effectiveness of MRI and contrast-enhanced mammography was about three times greater than ultrasound in identifying early tumors.

Women with extremely dense breasts—around 10% of those in this age group—are at a fourfold higher risk of developing breast cancer compared to women with less dense tissue. While traditional mammography may miss many early tumors in these women, the addition of advanced imaging techniques shows promise in catching cancers that could otherwise go unnoticed, potentially saving lives. However, further studies are necessary to determine if these methods can reduce breast cancer mortality rates, assess the risks of overdiagnosis, and evaluate the cost-effectiveness of incorporating such strategies into routine screening programs.

Fiona Gilbert, a professor at the University of Cambridge, emphasizes the global relevance of these findings, noting that countries worldwide could benefit from adopting supplementary imaging to improve early detection in women with dense breasts.

This pioneering research underscores the importance of personalized cancer screening strategies and may ultimately lead to more effective early detection protocols, especially for women at higher risk due to dense breast tissue. Ongoing research will help clarify the long-term benefits and practicality of implementing these advanced techniques universally.

For more detailed information, the full study can be accessed via DOI: 10.1016/S0140-6736(25)00582-3.