Wendie Berg, MD, PhD, FACR

To improve the precision of breast cancer detection in women with a higher-than-average risk of breast cancer.

Impact

Women who have been treated for breast cancer are at increased risk for recurrence and second breast cancers. Unfortunately, current mammography is inadequate for detecting breast cancers in this population and the capacity for widespread MRI is limited and costly. Women with dense breasts also face limits in screening options since mammography can miss early lesions. Ultrasound, which is sometimes recommended for women with dense breasts, has a high rate of false positives and is also not widely available. Dr. Berg is assessing alternative methods of screening for these populations that could provide more precise results—this includes assessment of artificial intelligence to enhance ultrasound and comparing the sensitivity and specificity of 3D mammography (tomosynthesis) screening alone versus 3D plus contrast-enhanced mammography (CEM). Her research will help optimize screening practices for women with recurrent breast cancer or dense breasts and has the potential to further reduce mortality from breast cancer.

Progress Thus Far

She is also continuing to recruit patients to a multi-year study to test whether CEM and 3D mammography provides a feasible more effective and lower cost option of breast cancer detection than tomosynthesis alone or MRI. In the last year, Dr. Berg and her colleagues enrolled an additional 578 women to the study and are nearing the planned goal of 1647 participants. Another 383 women have completed their second year of screening and 44 have completed the third round of screening. In addition, they have initiated the fourth and final round of annual screening. To date, the performance of CEM is similar to MRI, but with fewer callbacks and false positives.

What’s next

Dr. Berg’s team is on track to complete accrual for the group of participants to receive their first screening, while screening continues for participants in their second, third and fourth years—all participants will undergo screening over four years. Her team is also evaluating patient tolerance for CEM compared to MRI. The results of these studies will inform screening strategies by providing good estimates of cancer detection with annual CEM, interval cancer rates, and false positives. Analysis is ongoing in Dr. Berg’s clinical trial to test AI-enhanced ultrasound technology called Computer-Aide Diagnosis (CADx) in women with dense breasts. Since early detection of breast cancer improves outcomes and reduces the risk of recurrence or metastasis, Dr. Berg’s research will help optimize screening practices and has the potential to further reduce mortality from breast cancer.