New state insurance bills, UK BRAID trial published
State Insurance Bills
Newly introduced state insurance bills to cover expanded breast imaging include the following:
European News: Just Published
Prevalence supplemental screening results from the randomized UK BRAID trial were published 5/21/2025 in The Lancet. More than 9300 women with dense breasts and negative 2D mammogram aged 50-70 years were randomized to one of four screening groups (over 2000 women in each group): supplemental screening with abbreviated MRI (AB-MRI), automated whole breast ultrasound (ABUS), contrast-enhanced mammography (CEM), or standard of care (no supplemental screening).
Finding: Supplemental screening in women with dense breasts results in earlier detection, with AB-MRI and CEM finding more cancers than ABUS with higher recall rates.
- Cancer detection rates were higher for AB-MRI and CEM than for ABUS, but all modalities significantly increased cancer detection.1
- Recall rates were higher for AB-MRI and CEM than for ABUS.2
- Among those women invited to supplemental screening, participation rates were highest among women invited to have ABUS.3
- All cancers detected were small, but cancers seen with contrast methods were smaller.3
- All cancers detected by ABUS were invasive, as were 82% and 86% detected by CEM and AB-MRI, respectively.3
- Just over 1% of women having CEM experienced a contrast reaction.4
Note: Added cancer detection rates in this study were higher than most prior reports for AB-MRI, ABUS, or CEM, likely because of longer interval between the initial mammogram and the supplemental screening (median 3-4 months, but up to one year). Added yields are expected to be somewhat lower after tomosynthesis and in incidence screening. Normal cases were offered a second round of screening at 18 months; interval cancer rates are not yet known as there has not been sufficient follow-up.
1 Added cancer detection rates for AB-MRI, ABUS, and CEM were 17.4/1000, 4.2/1000, and 19.2/1000, respectively. Cancer detection rates were significantly higher for AB-MRI and CEM than for ABUS. A control group at Cambridge having only digital mammography had a cancer detection rate of 8.4/1000: supplemental contrast-enhanced screening more than doubled cancer detection.
2 Recall rates were 9.7%, 4.0%, and 9.7%, for AB-MRI, ABUS, and CEM, respectively.
3 Approximately 95.5% of invited women completed ABUS vs. 91.8% AB-MRI and 91.1% CEM.
3 Median invasive cancer size for AB-MRI, ABUS, and CEM respectively was 10 mm (IQR: 8-15 mm), 22 mm (IQR: 14 – 35 mm) and 11 mm (7 – 15 mm). Invasive-only added cancer detection rates were: 15.0/1000, 4.2/1000, and 15.7/1000 for AB-MRI, ABUS, and CEM respectively.
4 Among 2035 women having CEM, 17 had minor contrast reactions (8.4 per 1000); 6 had moderate (2.9 per 1000) and 1 severe (0.5/1000). There were no contrast reactions with MRI. Another 3 women had contrast extravasation with CEM as did one (of 2130) with MRI).