Lancet

Dense breasts & supplemental imaging: MRI vs. ultrasound vs. contrast-enhanced mammography

June 3, 2025

Contrast-enhanced methods such as MRI and contrast-enhanced mammography detected 3 times as many invasive cancers vs. whole-breast ultrasound for supplemental imaging in patients with dense breasts and normal mammograms, according to this single-cohort RCT of women at average breast cancer risk.

Study details. The multi-site BRAID study (NCT04097366) randomized 9,361 women (age, 50–70 years) with dense breasts and negative mammograms to abbreviated MRI, iodinated contrast-enhanced mammography, automated whole-breast ultrasound, or standard of care (full-field digital mammogram). Images were double read. Primary outcome: cancer detection rate; secondary outcomes: recall rates on positive results, tumor characteristics.

Results. Detection rates with MRI were significantly higher vs. automated whole-breast ultrasound (p = 0.047), non-significantly higher vs. contrast-enhanced mammography (p = 0.62).

Adverse events. There was 1 case of extravasation in the MRI group, 24 iodinated contrast reactions (17 minor, 6 study moderate, 1 severe), 3 extravasations in the contrast-enhanced mammography group, and no adverse events in the ultrasound group.

Source:

Gilbert FJ, et al. (2025, May 31). Lancet. Comparison of supplemental breast cancer imaging techniques-interim results from the BRAID randomised controlled trial. https://pubmed.ncbi.nlm.nih.gov/40412427/