21 april 2020: Omdat ik een vraag kreeg over de effectiviteit van Ultra Sound bij kanker in het algemeen kwam ik bij mijn zoektocht enkele studies tegen over het gebruik van Ultra Sound als extra diagnose methode bij borstkanker zoals onderstaand artikel al in 2008 geplaatst.

Bv. deze studie: Breast cancer detection using sonography in women with mammographically dense breasts.

Met als conclusie: 

Borst-echografie (Ultra Sound) als aanvullend beeldvormingsinstrument ontdekte 27% meer kwaadaardige borst-laesies die anders door een standaard mammografie werden gemist bij deze symptomatische (= vrouwen met klachten die zouden kunnen duiden op borstkanker) vrouwen met mammografisch dichte borsten. We raden Ultra Sound aan bij routinematige evaluatie van symptomatische vrouwen met mammografisch dichte borsten. Abstract staat onderaan artikel.

Ook deze reviewstudie uit 2019: Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis geeft uitstekende informatie over de waarde van een extra Ultra Sound diagnose naast een standaard borstkankerdiagnose bij vrouwen met grote borstdichtheid en bevestigft de resultaten uit eerder genoemde studie. Abstract plus referentielijst hiervan staat ook onderaan artikel.

18 november 2008: Bron: 1: Breast Cancer. 2008;15(2):165-8. Epub 2008 Jan 26.Click here to read Links
Wanneer een mammografie wordt uitgebreid met een diagnose met ultrasound dan worden nog eens 15% van verdacht weefsel op correcte wijze gediagnosteerd. Dit blijkt uit een gerandomiseerde studie onder ruim 9000 Japanse vrouwen. Zie hieronder het abstract van de studie.

Screening ultrasonography revealed 15% of mammographically occult breast cancers.

Department of Breast and Endocrine Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan, kenucd@jikei.ac.jp.

BACKGROUND: Mammography and physical examination (PE) are the recommended modalities for breast-cancer screening for women 40 years and older in Japan. Mammography, however, cannot detect lesions in dense breast tissue, which is common in Japanese women. Breast screening by ultrasound (US) is popular in Japan. We studied which modality or combinations of modalities optimize breast cancer detection for Japanese women.

METHODS: From April 1993 through March 2005 we found 97 breast cancers in 9,082 women by screening examinations with mammography, US, and PE. We compared the detection rates of these three modalities for breast cancer.

RESULTS: The detection rates of mammography, US, and PE for breast cancer were 83.5 (81 of 97 cancers), 75.3 (73 of 97 cancers), and 60.8% (59 of 97 cancers), respectively. The detection rates of the combinations of mammography and US, mammography and PE, and US and PE were 99.0 (96 of 97 cancers), 88.7 (86 of 97 cancers), and 81.4% (79 of 97 cancers), respectively. Ultrasonography detected 15% of the mammographically occult breast cancers.

CONCLUSION: Screening with the combination of mammography and US significantly increases the detection rate of breast cancer. These results suggest that screening with mammography and US would optimize cancer detection in Japanese women.

PMID: 18224382 [PubMed - in process]

Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.

 2014 Dec 30;14:41. doi: 10.1186/s12880-014-0041-0.

Breast cancer detection using sonography in women with mammographically dense breasts.



Mammography, the gold standard for breast cancer screening misses some cancers, especially in women with dense breasts. Breast ultrasonography as a supplementary imaging tool for further evaluation of symptomatic women with mammographically dense breasts may improve the detection of mass lesions otherwise missed at mammography. The purpose of this study was to determine the incremental breast cancer detection rate using US scanning in symptomatic women with mammographically dense breasts in a resource poor environment.


A cross sectional descriptive study. Women referred for mammography underwent bilateral breast ultrasound, and mammography for symptom evaluation. The lesions seen by both modalities were described using sonographic BI-RADS lexicon and categorized. Ultrasound guided core biopsies were performed. IRB approval was obtained and all participants provided informed written consent.


In total 148 women with mammographically dense breasts were recruited over six months. The prevalence of breast cancer in symptomatic women with mammographically dense breasts was 22/148 (15%). Mammography detected 16/22 (73%) of these cases and missed 6/22 (27%). The six breast cancer cases missed were correctly diagnosed on breast ultrasonography. Sonographic features typical of breast malignancy were irregular shape, non-parallel orientation, non circumscribed margin, echogenic halo, and increased lesion vascularity (p values < 0.005). Typical sonofeatures of benign mass lesions were: oval shape, parallel orientation and circumscribed margin (p values <0.005).


Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.


Portable ultrasound could serve as a global primary detection modality and triage method for breast lesions, particularly in low-resource areas where mammography is currently unavailable or infeasible.

 2019 Aug;5:1-17. doi: 10.1200/JGO.19.00127.

Ultrasound for Breast Cancer Detection Globally: A Systematic Review and Meta-Analysis.



Mammography is not always available or feasible. The purpose of this systematic review and meta-analysis is to assess the diagnostic performance of ultrasound as a primary tool for early detection of breast cancer.


For this systematic review and meta-analysis, we comprehensively searched PubMed and SCOPUS to identify articles from January 2000 to December 2018 that included data on the performance of ultrasound for detection of breast cancer. Studies evaluating portable, handheld ultrasound as an independent detection modality for breast cancer were included. Quality assessment and bias analysis were performed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity analyses and meta-regression were used to explore heterogeneity. The study protocol has been registered with the international prospective register of systematic reviews (PROSPERO identifier: CRD42019127752).


Of the 526 identified studies, 26 were eligible for inclusion. Ultrasound had an overall pooled sensitivity and specificity of 80.1% (95% CI, 72.2% to 86.3%) and 88.4% (95% CI, 79.8% to 93.6%), respectively. When only low- and middle-income country data were considered, ultrasound maintained a diagnostic sensitivity of 89.2% and specificity of 99.1%. Meta-analysis of the included studies revealed heterogeneity. The high sensitivity of ultrasound for the detection of breast cancer was not statistically significantly different in subgroup analyses on the basis of mean age, risk, symptoms, study design, bias level, and study setting.


Given the increasing burden of breast cancer and infeasibility of mammography in certain settings, we believe these results support the potential use of ultrasound as an effective primary detection tool for breast cancer, which may be beneficial in low-resource settings where mammography is unavailable.



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Articles from Journal of Global Oncology are provided here courtesy of American Society of Clinical Oncology

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