U.S. State Insurance Updates, UK BRAID trial + ABUS Results in Korea
U.S. State Insurance Bills
New 2026 insurance bill introductions for expanded breast imaging include: Indiana HB1112 and Kentucky HB135
BRAID RSNA Presentations and Automated US Study
Additional BRAID Trial Results
Several sessions at RSNA 2025 showed second round results from the UK BRAID trial led by Dr. Fiona Gilbert. The initial trial enrolled 9361 women age 50-70 from October 2019-March 2024 with dense breasts and a negative mammogram who were randomized to receive supplemental screening with automated breast ultrasound (ABUS), abbreviated MRI (AB-MRI), or contrast-enhanced mammography (CEM), with results published in The Lancet in May 2025. Women with a negative result from the initial supplemental screen who enrolled by 3/31/23 were invited to have a second round of screening 18 months later that included mammography (MG).
- Cancer detection rates in the second round of screening were similar for each of ABUS, AB-MRI, and CEM arms at about 8/1000.1
- Recall rates decreased for both AB-MRI and CEM in the second round but were similar to the first round for ABUS.2
1 Cancer detection rates were 15/1572 (9.5/1000) for ABUS+MG; 9/1051 (8.6/1000) for AB-MRI+MG; and 6/870 (7.0/1000) for CEM in the second round. [By comparison, cancer detection rates in the first round were 4.2/1000 for ABUS; 17.4/1000 for AB-MRI; and 19.2/1000 for CEM after a negative mammogram.]
2 Recall rates in the second round were 4.3% for ABUS; 3.5% for AB-MRI; and 4.7% for CEM. In the first round, recall rates were 4.0% for ABUS; 9.7% for AB-MRI; and 9.7% for CEM.
ABUS in Non-dense Breasts
Two referral centers in Korea retrospectively reviewed results of screening women with non-dense breasts and compared performance of digital mammography (DM) alone vs DM + automated breast ultrasound (ABUS). They reviewed 2904 paired screening examinations among 1683 women with non-dense breasts.
- Adding ABUS to DM slightly increased cancer detection in women with scattered fibroglandular density, but not in women with fatty breasts.1
- The small increase in cancer detection was accompanied by a small increase in false positive recalls.2
- Women diagnosed with breast cancer were older (63 ± 9 years vs. 59 ± 10 years, P = 0.04) and tended to have risk factors (19.2% vs. 4.2%, P < 0.001) compared to those without breast cancer.