Breast Screening – Risk Adaptive Imaging for Density

In the UK, the NHS Breast Screening Programme (NHSBSP) invites women aged between 50-70 to have a mammogram every three years. Women known to be at high risk of developing breast cancer, due to specific gene mutations for example, are invited to more regularly screening from a younger age which may also include a Magnetic Resonance Imaging (MRI) scan.

The BRAID trial is a multicentre study focused on women within the standard breast screening programme who are found to have radiographically dense breast tissue – that is to say a breast containing a large percentage of fibroglandular tissue which attenuates the x-ray beam much more than the otherwise fatty tissue. Dense breast tissue is a concern for two reasons; women with dense breast tissue are at heightened risk of developing breast cancer and the mammographic appearance represents a diagnostic challenge for radiologists as the dense tissue can act to mask or obscure the small lesions they are looking to detect.

With the diagnostic value and sensitivity of mammography reduced in women with dense breast tissue; the BRAID study is investigating the use of supplemental imaging techniques to address this problem. Women recruited into the study are randomised to one of four arms, either receiving the standard of care or imaging from one of three different modalities; automated breast ultrasound (ABUS), contrast-enhanced spectral mammography (CESM), or abbreviated breast MRI (AB-MRI).

Supplemental imaging are performed at baseline and repeated 18 months later, with all participants followed-up for on up to two subsequent screening rounds. The primary outcome measure for the trial is the cancer detection rate for each arm.

Current study centres:

• Cambridge University NHS Foundation Trust (Chief Investigator – Prof Fiona Gilbert)
• Gloucestershire Hospitals NHS Foundation Trust (Principal Investigator – Dr Sarah Vinnicombe)
• Leeds Teaching Hospital NHS Trust (Principal Investigator – Dr Nisha Sharma)
• Manchester University NHS Foundation Trust (Principal Investigator – Dr Anthony Maxwell)

Technologies

• Magnetic Resonance Imaging (MRI)
• Automated Breast Ultrasound (ABUS)
• Contrast Enhanced Spectral Mammography (CESM)
• Full-Field Digital Mammography (FFDM)

Research Staff

Principal Investigator:

• Professor Fiona J Gilbert

Research Associates:

• Doctor Nicholas Payne  – Medical Physicist
• Jaimie Taylor – Project Manager
• Kirsten Morris – Research Radiographer

Visitors:

• Doctor Iris Allajbeu – Visiting Researcher

Support Staff

• Johanna Field-Rayner – Research Nurse

Funding