Researchers in Cambridge are calling for additional scans to be added to breast screening for women with very dense breasts. This follows a large-scale trial, which shows that extra scans could treble cancer detection for these women potentially saving up to 700 lives a year in the UK.
We need to change our national screening programme so we can make sure more cancers are diagnosed early, giving many more women a much better chance of survival
Fiona Gilbert
Around 10% of women have very dense breasts. Between the ages of 50 and 70, these women are up to four-times more likely to develop breast cancer compared to women with low breast density.
Over 2.2 million women receive breast screening in the UK each year. For women with very dense breasts, mammograms (breast X-rays), which are used for breast screening, can be less effective at detecting cancer. This is because denser breasts look whiter on mammograms, which makes it harder to spot small early-stage cancers which also appear white.
Published today in The Lancet, a trial of over 9000 women across the UK who have dense breasts and had a negative (no cancer) mammogram result, found 85 cancers.
The trial, called BRAID, tested different scanning methods that could be used in addition to mammograms to detect cancers in dense breasts. Per 1000 women screened, two of the methods detected 17-19 cancers that were not seen in mammograms.
The two methods are known as CEM (contrast enhanced mammography) and AB-MRI (abbreviated magnetic resonance imaging).
The researchers that ran the trial recommend that adding either of these methods to existing breast screening could detect 3,500 more cancers per year in the UK. Estimates suggest that screening reduces mortality for about 20% of cancers detected, so this could mean an extra 700 lives saved each year.
BRAID also included a third scanning method, ABUS (automated whole breast ultrasound), which also detected cancers not seen in mammograms but was three times less effective than CEM and AB-MRI.
Each of the three methods was used to scan around 2000 women. Per 1000 women scanned, CEM detected 19 cancers, AB-MRI found 17 cancers, and ABUS found 4.
Mammograms already detect approximately 8 cancers per 1000 women with dense breasts. This means additional scans could more than treble breast cancer detection in this group of women.
BRAID is the first trial to directly compare supplemental imaging methods and to demonstrate their value for early cancer detection as part of widespread screening. The team hope their results will be used to enhance screening programmes in the UK and globally to diagnose more cancers early.
More work is needed to confirm whether additional scans will reduce the number of deaths as cancers detected through screening are not always life-threatening.
The trial was led from Cambridge. It recruited across 10 UK sites, including over 2000 women at Addenbrooke's Hospital, Cambridge.
The research was led by Professor Fiona Gilbert, Department of Radiology, University of Cambridge and honorary consultant radiologist at Addenbrooke's Hospital, part of Cambridge University Hospitals NHS Foundation Trust (CUH). The trial was funded by Cancer Research UK with support from the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre (BRC).
Professor Gilbert said: "Getting a cancer diagnosis early makes a huge difference for patients in terms of their treatment and outlook. We need to change our national screening programme so we can make sure more cancers are diagnosed early, giving many more women a much better chance of survival."
Professor Stephen Duffy, Emeritus Professor, Queen Mary University, London, trial statistician and screening programme expert said: "The NHS Breast Screening Programme has made a huge difference to many lives. Thanks to these results we can see that the technology exists to make screening even better, particularly for the 10% of women with dense breast tissue."
Dr David Crosby, head of prevention and early detection at Cancer Research UK, said: "Breast cancer screening is for people without symptoms and helps to spot the disease at an early stage, when treatment is more likely to be successful. But having dense breasts can make it harder to detect cancer.
"This study shows that making blood vessels more visible during mammograms could make it much easier for doctors to spot signs of cancer in women with dense breasts. More research is needed to fully understand the effectiveness of these techniques, but these results are encouraging.
"Remember, having dense breasts is not something you can check for yourself or change, but if you're concerned at all, you can speak to your GP."
Reference
Gilbert, FJ et al. Comparison of supplemental imaging techniques - interim results of BRAID (Breast Screening: risk adapted imaging for density) randomized controlled trial. Lancet; 22 May 2025; DOI: 10.1016/S0140-6736(25)00582-3
Press release from Cambridge University Hospitals NHS Foundation Trust
