Breast cancer is the most common malignant disease in women and the leading cause of death both worldwide and in Bulgaria. According to the latest WHO data, the risk of developing breast cancer in Western Europe is 9.5%, which means that 1 in 11 women will develop the disease by the age of 74. In Bulgaria, the risk is 5.7%, or 1 in 18 women will be diagnosed with breast cancer. Despite the lower risk, the incidence of new cases and mortality from breast cancer in Bulgaria remains significantly high. In 2022, 3,558 new cases were registered, making it the third most common disease in both sexes after lung and colorectal cancer.
The data are particularly alarming for women under 50, who account for 20% of newly diagnosed breast cancer cases. Bulgaria ranks third in the EU for breast cancer mortality among women under 50. Although the risk of developing breast cancer in women of this age is about 1.5%, additional risk factors such as family history, dense breast tissue, hormone replacement therapy and other gynaecological problems significantly increase this risk.
Prevention is the key to reducing the risk of developing breast cancer, especially for women at high risk. The breast cancer prevention programme at Preventica is designed to meet the needs of each woman through a personalised approach. The programme includes:
This approach provides not only early detection, but also proactive measures to maintain optimal health.
ABUS: An innovation for early diagnosis
A key element of the program is the use of the innovative Automated Breast Ultrasound (ABUS), which provides higher accuracy in diagnosis. This is particularly important for women with dense breast tissue, where traditional methods such as mammography and standard ultrasound can miss important details. ABUS provides three-dimensional images that allow better visualisation of the breast, including the deep tissue. The results are interpreted by a certified specialist, ensuring more accurate and objective data.
Analysis of screening in Europe and the USA
In many European countries, such as the Netherlands, the UK and Sweden, mammography is the primary screening method for breast cancer and has been shown to reduce mortality from the disease. However, mammography can be less effective in women with dense breast tissue. To overcome this problem, additional technologies such as ABUS and standard ultrasound are increasingly being used in the US and Europe. The combination of these methods allows better detection of cancerous growths, especially in younger women with denser breasts.
Advantages of ABUS over standard ultrasound
Women under 50 often have denser breast tissue, which can make it more difficult to detect abnormalities with both mammography and standard ultrasound. ABUS provides significant advantages in these cases. While standard ultrasound depends on the skill of the operator and the quality of the equipment, ABUS provides an automated and standardised scan of the whole breast, minimising the possibility of error and providing consistent results. This is particularly important in Bulgaria, where the lack of standardisation in the quality of ultrasound equipment and the lack of specialist training in breast disease lead to significant variations in image interpretation.
Key advantages of ABUS
One of the main advantages of ABUS is its ability to produce a coronal projection of the breast - a unique view that cannot be achieved with conventional ultrasound. This projection makes it possible to detect the phenomenon of retraction - an important marker for distinguishing benign from malignant lesions. Retraction is a retraction or tightening of the tissue around the lesion that often goes undetected by standard ultrasound.
ABUS allows specialists to view the breast from different angles and in greater detail, significantly improving the accuracy of the diagnosis. This is particularly important for women with dense breast tissue, where standard methods may not provide sufficiently reliable results. ABUS offers better visualisation and greater diagnostic accuracy, making it ideal for screening and prevention in women at increased risk.
The author: Dr Ivan Inkov, thoracic surgeon and mammologist
