Professor of Radiology, Magee-Womens Hospital
University of Pittsburgh Medical Center
Studies are focused on improving the precision of breast cancer detection in women with dense breasts.
A clinical trial is examining the role of whole breast screening ultrasound (WBUS) for detecting breast cancer in women with dense breasts following 3D mammography.
These are important studies in improving early detection of breast cancer while reducing false positives in women with dense breasts.
Over 40 percent of women have dense breasts, and for this population, screening mammograms and even 3D mammograms are limited, as cancer can be difficult to see in dense tissue. Women with dense breasts also have a risk of developing breast cancer that is 1 to 2 times higher than women with average breast density. At present, dense breast notification laws have been passed in 31 states that require some information be provided to the patient regarding limitations of mammography in dense breasts.
The ACRIN 6666 clinical study of asymptomatic women that was led by Dr. Berg, in which screening ultrasound was added to mammography, showed a significant increase in cancer detection in women with dense breasts over mammography alone. However, adding screening ultrasound to augment mammography in women with dense breast tissue also resulted in many more false positives.
Dr. Berg is leading an NIH-funded clinical trial that is examining the role of technologist-performed whole breast screening ultrasound (WBUS) for detecting breast cancer in women with dense breasts after 3D mammography. The team is examining the effectiveness of using computer-aided diagnosis software (CADx) to assist in reducing the number of false positives and improving the specificity of whole-breast ultrasound. This study builds on the team’s prior work by testing two extreme approaches to CADx: precise detection of cancers vs. precise detection of benign lesions.
This work is very important for determining the optimal approach to using a computer second opinion in clinical practice. Using CADx, Dr. Berg believes that the rate of false positives can be significantly reduced without affecting the ability to detect cancers. If successful, prospective clinical evaluation would follow. These studies are expected to improve the accuracy of detecting cancer in women with dense breast tissue.
Wendie A. Berg, MD, PhD, FACR, is Professor of Radiology at Magee-Womens Hospital of UPMC, University of Pittsburgh School of Medicine, and is well known for her role as Study Chair and PI of ACRIN 6666, Screening Breast Ultrasound and MRI in High-Risk Women. Dr. Berg trained at Johns Hopkins University School of Medicine where she received MD and PhD (Pharmacology) degrees in 1987 and completed residency in Diagnostic Radiology in 1992. She worked on BI-RADS Ultrasound and Mammography lexicons, has authored or coauthored over 90 peer-reviewed publications, co-writes and edits the book, Diagnostic Imaging: Breast (2 editions), has led and authored results of multicenter clinical trials evaluating breast PET and shear-wave elastography, and is currently conducting a prospective multicenter study of screening ultrasound after tomosynthesis in women with dense breasts. She has received multiple awards for reviewing and research mentoring, and was awarded “Teacher of the Year” by residents of University of Maryland. She was elected an honorary fellow of the Austrian Roentgen Society in 2012 for her contributions to the design of the Austrian Breast Cancer Screening Program. Recognizing her efforts to evaluate and implement supplemental screening methods for women with dense breasts, Dr. Berg received the 2012 Global Breast Cancer Medical Achievement Award from the Avon Breast Cancer Crusade. In 2013, she was awarded the Pathfinder lectureship of the American Society of Breast Disease, and in 2015 she received the Pink Ribbon Award from the Pennsylvania Breast Cancer Coalition. Dr. Berg is Chief Scientific Advisor to www.DenseBreast-info.org.