Enhanced imaging detects significantly more cancers in dense breasts compared to conventional mammograms

Mammograms showing breast density. The image on the right shows the difficulty of spotting anomalies in dense breasts. (Image credit – American Cancer Society)

CANCER DIGEST – May 24, 2025 – Adding enhanced imaging for breast cancer screening of women with dense breasts could triple the rate of early cancer detection among these women, a clinical study at Cambridge University in the UK shows. Results of the BRAID trial were published in the May 21, 2025 journal The Lancet.

While most breast cancers can be detected with regular mammograms, around 10 percent of women have what are called dense breasts, meaning the image is very cloudy, making it harder to spot suspicious lesions. Research shows that these women are up to four times more likely to develop breast cancer compared to women with less dense breasts.

In the study, the UK researchers led by Professor Fiona Gilbert in the Department of Radiology at the University of Cambridge, 9,361 women with dense breasts as shown on standard mammograms underwent additional screening using one of three screening methods.  Of 6,306 women who completed the trial, 2,130 of them underwent what is called abbreviated MRI (AB-MRI), another 2,141 received automated breast ultrasound (ABUS), and 2,035 received contrast enhanced mammography (CEM) using a dye injected into the blood prior to the mammogram.

Overall the additional screening detected 85 cancers that had not been found with standard mammograms. AB-MRI detected 37 cancers, ABUS detected 9 cancers, and CEM detected 39 cancers. 

The results showed that the AB-MRI had a detection rate of 17.4 breast cancers per 1,000 screens, the ABUS detected 4.2 tumors per 1,000 women screened, and CEM had a detection rate of 13.7 tumors per 1,000. The AB-MRI and CEM detection rates were considered significantly higher compared to standard mammography. The detection rate for ABUS was not significantly higher than standard imaging.

The significantly higher detection rates for AB-MRI and CEM suggests a change to screening women with dense breasts is called for according to Dr. Gilbert.

"We need to change our national screening program so we can make sure more cancers are diagnosed early," she said in a press release. "giving many more women a much better chance of survival." 

Sources: University of Cambridge press release and The Lancet