Why aren't we doing this?
My oncologist has told me about a screening tool that I feel others should know about. It is called SonoCine. I have triple negative, stage 1 and have very dense breasts.
SonoCine is an adaptation to ultrasound screening. I have had three of these scans in the past two years. I am now a booster for spreading the info on this procedure as I have just read a paper on how it doubles the rates of finding small cancers in dense breasts as compared to mammography alone.
Here is the abstract from the published paper:
Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts
Kevin M. Kelly,corresponding author1 Judy Dean,2 W. Scott Comulada,3 and Sung-Jae Lee3
1Huntington Memorial Hospital, Huntington-Hill Breast Center, Pasadena, CA USA
21525 State St. Suite 102, Santa Barbara, CA 93101 USA
3Semel Institute Center for Community Health, University of California, Los Angeles, CA USA
Kevin M. Kelly, Phone: +1-626-7936141, Fax: +1-775-2561845, Email: drkelly@ca.rr.com.
Contributor Information.
corresponding authorCorresponding author.
Received May 14, 2009; Revised July 27, 2009; Accepted August 7, 2009.
Small right arrow pointing to: This article has been cited by other articles in PMC.
* Other Sections▼
o Abstract
o Introduction
o Materials and methods
o Results
o Discussion
o Conclusion
o References
Abstract
Purpose
Mammography, the standard method of breast cancer screening, misses many cancers, especially in dense-breasted women. We compared the performance and diagnostic yield of mammography alone versus an automated whole breast ultrasound (AWBU) plus mammography in women with dense breasts and/or at elevated risk of breast cancer.
Methods
AWBU screening was tested in 4,419 women having routine mammography (Trial Registration: ClinicalTrials.gov Identifier: NCT00649337). Cancers occurring during the study and subsequent 1-year follow-up were evaluated. Sensitivity, specificity and positive predictive value (PPV) of biopsy recommendation for mammography alone, AWBU and mammography with AWBU were calculated.
Results
Breast cancer detection doubled from 23 to 46 in 6,425 studies using AWBU with mammography, resulting in an increase in diagnostic yield from 3.6 per 1,000 with mammography alone to 7.2 per 1,000 by adding AWBU. PPV for biopsy based on mammography findings was 39.0% and for AWBU 38.4%. The number of detected invasive cancers 10 mm or less in size tripled from 7 to 21 when AWBU findings were added to mammography.
Conclusion
AWBU resulted in significant cancer detection improvement compared with mammography alone. Additional detection and the smaller size of invasive cancers may justify this technology's expense for women with dense breasts and/or at high risk for breast cancer.
Keywords: Mammography, Ultrasound, Breast cancer, Screening, Automated
Here is the full paper ID which has open access. Simply copy this number into the google search:
DOI 10.1007/s00330-009-1588-y
Comments
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Oops, I meant detection of small invasive cancers was tripled....even better.
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MsBliss,
I just had this scan done due to my dense and "busy" breasts and family history. As a result I had 5 biopsies yesterday because it found some solid nodules that are not cysts (praying for benign results!). None of these things were found on my Mamo or MRI. My insurance did not pay for it but I decided to have it done at the suggestion of my BS after my recent mamo was Birads 2 (fibroadenomas)-not sure anyone can see anything in that dense tissue. I agree with you and I think it is a very good test to add to a mamo for those of us with dense breasts. Did you have this scan before you were diagnosed or as follow up?
Thanks for sharing this information.
Amy
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I was wondering how Sono Cine differs from conventional breast ultrsound. I also have very busy breasts and have been having routine ultrasounds every six months. It usually takes 30 - 60 mins to complete an ultrasound exam bilaterally on my breasts, I wonder if this would shortn the exam time and accuracy.
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I think that the Sonocine takes more pictures and then the images are pieced back together for a 2D-3D picture. My Dr said that it gives a better, clearer look at the breast so that depth is not an issue. It is computer guided and takes images in long strips from the armpit inward. For me the procedure too about 30-60 minutes but then they had to go back and look at all my busy areas again (sigh). The company information states that the procedure takes 15 minutes-probably for those with less busy breasts. I am by no means an expert on Sonocine but am curious about others who have done this procedure.
edited for bad spelling
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Thanks for the info Amykd, I think I"ll research as to whether there is any facility in the ft. lauderdale area using Sonocine.
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From what I understand, an ultrasound is about 30 to 40 pictures; Sonocine is thousands of pictures, in multiple dimensions. Also, ultrasound is operator dependent....that is, their hand pressure affects the accuracy; sonocine is partially robotic, so it is more accurate.
The first time I saw my scan, it was absolutely eye opening.I did not find out about sonocine until after my diagnosis. But I intend to keep it as my primary scan for local check ups.
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Thanks so much for posting this. The dense breasts issue is not being addressed properly by most doctors. I don't know when they are going to get it. Why not just put a poster on the wall of all doctors offices that states "Dense Breasts Means More Risk of Cancer".
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I am really in favor of SonoCine from what I've learned so far. Is this related to thermography in any way? I am scheduled to get a thermogram next week.
Lisa
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Interesting question....
I had dense breasts prior to treatment. My tumor was discovered by mammography and ultrasound, but all the same it is an interesting question.
Radiology Associates of Albuquerque, Pennsylvania's page indicates the SonoCine is just $50? Is that accurate? Can anyone who has had it done comment on that?
Does SonoCine require any kind of injection of contrast, or radiation imaging? If it is that good.... and doesn't use radiation... that would be a benefit in itself.... I wonder too if it requires the breasts to be smooshed or not. Another potential benefit. At present, due to radiation necrosis of my IMRT treated breast, my poor overexposed mammary gland genuinely is so painful that I am looking at having an MRI instead of a mammogram for the first time in 9 long years of imaging.
But RAA of Penn indicates that the ACR (American College Of Radiation?) does not support the use of SonoCine for whole breast imaging, only for imaging after a mammogram has identified a questionable lump. What is the rationale for not endorsing whole-breast imaging -- is it a lack of certainty at this point whether it is useful or not (meaning just that additional verification is needed), or a sign that there is a problem with whole-breast imaging using this method? Or is it a way of maintaining the status quo, with all the mammo equipment that is now in place with rads people trained to do mammos and not a new technology?
RAA of Penn's page about SonoCine:
http://www.raaonline.com/html/services/sonocine.html
Article from a European radiology journal:
http://www.ncbi.nlm.nih.gov/pubmed/19727744?dopt=Abstract
CONCLUSION: AWBU resulted in significant cancer detection improvement compared with mammography alone. Additional detection and the smaller size of invasive cancers may justify this technology's expense for women with dense breasts and/or at high risk for breast cancer.
Where is SonoCine available? I'm interested.
AlaskaAngel
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Sonocine indicates it is not a replacement for mammography (possibly because it doesn't detect calcifications like mammos do):
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Well, what I have learned is that it is a stand alone screening, which is what I am doing, but better still, a complement to mammography. My triple negative tumor, which was almost 1.5 cm was INVISIBLE, completely occult, on my mammogram. The only reason it was found was because I COULD FEEL IT. We put a radio bead marker on it, took a mam, and it was not visible, even with the knowledge of where it was supposed to be.
To answer some questions, no there is no radiation or contrast medium. It is simply ultrasound, but super efficient ultrasound that visualizes more tissue because it takes thousands of images instead of dozens, and not subject to the uneven hand pressure a ultrasound hand held hand piece would create.
It is not related to thermography. I used to do thermography as well, but have switched to Sonocine exclusively.
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Dear Amykd--I am using Sonocine for follow up.
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As far as cost...because it is not covered by insurance I paid $300. It is still considered experimental but in a year or 2 it might be covered (what my BS said). Sonocine is not a replacement for mammogram but it give another way to look at dense breasts just like a MRI does. It does not require any contrast like an MRI does. It is exactly like an ultrasound with gel and all. The radiologist uses a computer guided arm and directs it in strips down your breast starting by your armpit. Interestingly, I got my letter saying my mammo was clear on the same day the Sonocine found 5 areas to biopsy. I am currently scheduled to have a radial scar removed (undetected by mammo due to dense breasts). I do not have extremely dense tissue but dense enough. I plan to have it as a compliment to my mammos.
Amy
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