The countable rise of breast cancer incidence globally has heightened pressures for government screening programmes, and strengthened awareness of the benefits of breast cancer screening. However, screening programmes alone are not sufficient to help combat breast cancer mortality rates. It is imperative that accuracy of breast cancer detection is improved, whilst false positives and missed lesions are also reduced. These factors are forecast to be at the forefront of advancement in mammography screening techniques.This, alongside a patient-centric approach to screening and technological advancements to enhance patient comfort, are improvements being implemented to drive the uptake of mammography X-ray equipment.
Increased focus on patient comfort
The direct correlation of enhanced patient comfort results in:
- Increased subsequent attendance of breast cancer screening sessions
- A positive breast cancer screening experience being shared increasing peer attendance
- Better-quality images produced due to lowered stress levels
All three outcomes facilitate why patient comfort is at the forefront of technological developments by mammography X-ray vendors. This trend is apparent in the in the North American market, which is predicted to account for 52.5% of the global X-ray market. For instance, GE Healthcare developed the first mammography system which allows patients to control breast compression. Hologic recently launched its Smart Curve system which features a proprietary curved surface that mirrors the shape of a woman's breast, to reduce pinching and allow better distribution of force over the entire breast. Reduced patient distress in the examination room results in less patient movement and better-quality images, and consequently better detection of breast cancer and improved final outcomes. Global revenues for mammography X-ray are forecast to grow at a CAGR of 4.9% from 2016 to 2021, with these patient centric advancements for mammography X-ray systems playing a fundamental role.
Innovative technology advances
Contrast enhanced spectral mammography is another procedure increasingly performed to improve detection in breast cancer screening. Compared with conventional mammography alone, contrast-enhanced spectral mammography (CESM) detects an additional 7.7% of lesions in recalled women, with most lesions being malignant. The low risks of using CESM as a workup tool make it a valuable addition to breast cancer care. Whereas, there is much speculation amongst certain countries, for instance Switzerland, CESM is a complementary breast imaging modality offering a potential solution for dense breast lesions. Initial clinical results are showing that CESM has better diagnostic accuracy compared to mammography alone and in combination with ultrasound, especially in dense breasts. This is another factor powering the growth of digital mammography X-ray, forecast at 6.0% and 9.8% CAGRs from 2016 to 2021 for 2D digital mammography and 3D tomosynthesis shipments respectively.
A further facilitator for both increased accuracy in breast cancer diagnosis and 3D tomosynthesis market growth, and subsequently the mammography X-ray market, is tomosysnthesis guided biopsies. Tomosynthesis guided biopsy is expected to help expand the number of mammographic lesions that are considered controllable. The reduction in both the anatomic noise and masking effect of overlapping tissues by tomosynthesis guided biopsies enables sequential analysis of thin breast sections through the reconstruction of images in multiple projections. The additional benefits of enhanced workflow, improved patient experience and a streamlined biopsy process lead to reduced procedure time by up to 25%. For instance, Hologic’s Brevera biopsy system launched in August 2017, is designed to increase biopsy accuracy with real-time imaging, in order to deliver valuable information at the point of care, enabling clinicians to make informed decisions with confidence for better patient outcome. With the increased uptake of 3-D breast biopsy projected, and wider acceptance and awareness of the adverse benefits of embedding tomosynthesis as part of the biopsy procedure, the 3D tomosynthesis market is forecast to account for 48% of the global mammography X-ray market by 2021.
Use of Artificial Intelligence in mammography
In the United States, a significant 30% of women are referred for surgery after their preliminary breast cancer screening appointment. To address this, US scientists are placing more emphasis on how breast artificial intelligence (AI) algorithms could reduce unnecessary surgery caused by false positives. Two niche companies actively using AI are iCAD and Cure Metrix who have developed algorithms specific to breast imaging. Machine learning models which incorporate both pathology slides alongside mammography images, as well as incorporate data points such as demographics, family history, biopsies and pathology reports, will be increasingly used in clinical practice to identify common trends amongst breast cancer lesions. Restoring faith into the reliable outcomes of mammography screening and harnessing the accuracy of artificial intelligence, will undoubtedly aid the participation of breast cancer screening and demand for 3D mammography X-ray systems. The 3D tomosynthesis market is forecast reach over $600 million through to 2021.
Mammograms play a fundamental role in the detection of breast cancers, but the occurrence of false positives consequently leads to benign lesions being operated on. With heightened pressures for breast cancer screening programmes to account for the rising female population qualifying for mammography screening, it is imperative that the number of false positives subsequently do not rise as a result. Advanced techniques in mammography screening such as artificial intelligence, tomosynthesis guided biopsy, contrast enhanced spectral mammography and improved patient comfort are all key initiatives to reduce the number of false positives, consequent unnecessary surgery and improve detection.