Breast Cancer Screening Tool Avoids Radiation, Compression, Contrast

Although mammograms are regarded as the gold standard for screening, they are not being used as widely as recommended. According to a recent survey by MedStar, 59% of eligible women skip their annual mammogram, while CDC figures indicate that about 23% do not adhere to the recommended screening schedule. The impact of this is substantial: this year, approximately 380,000 women in the U.S. are expected to be diagnosed with breast cancer, a number that has been rising for over a decade. Alarmingly, even women who get their mammograms on time are not entirely safeguarded, as the test fails to detect about one in eight breast cancers.

The gaps in screening and diagnosis are highlighted by the recent recommendation from the American College of Physicians, suggesting that women at average risk delay routine mammograms until age 50 and then screen every other year. This shift away from early widespread screening, which has been considered protective, has been critiqued by the American College of Radiology, which warned it “may contribute to thousands of additional breast cancer deaths each year.”

Amid these evolving guidelines, the medical field is increasingly focusing on adjunct tools that can enhance existing screening methods without increasing health risks. Clarity Health, for instance, uses AI to analyze mammograms and assess a patient’s future cancer risk. Its credibility is on the rise, with the National Comprehensive Cancer Network including this AI-based approach in its 2026 guidelines.

For many women, a ‘normal’ mammogram does not conclude the screening process. Last year, my own mammogram was deemed normal, yet it noted dense breast tissue, with no additional guidance. This uncertainty led me to explore better options for myself and others in similar situations.

To find more clarity, I consulted with experts developing new screening techniques. I spoke with Raluca Dinu, PhD, CEO, and Satrajit Misra, CCO, of QT Imaging, a company utilizing 3D ultrasound for breast cancer screening. They aim to enhance access to screening and diagnostic accuracy.

Why the Gold Standard Mammogram Isn’t Good Enough

Mammography is the only FDA-approved imaging method for breast cancer screening, yet as Dinu explains, “mammography still misses cancers today.” False negatives occur when cancer is present but not detected. A major factor in these false negatives is breast density, with about 40% of women having dense breast tissue, which 3D ultrasound aims to address. Dense tissue appears white on a mammogram, just like cancer, making it challenging to identify tumors. This issue elucidates why cancer detection is more difficult in dense tissue, which is also an independent risk factor for the disease. Typically, women with dense tissue turn to MRI for further examination, but this is costly, requires contrast injection, and needs interpretation by specialized radiologists. Alternatively, a handheld ultrasound by a trained sonographer is an option, but availability of skilled personnel is a barrier. According to Dinu, “60 to 70% of women today are in this middle, intermediate-risk group,” for whom the U.S. Preventive Services Task Force has no formal recommendation for additional screening with MRI or ultrasound.

What Does 3D Ultrasound Offer to Patients

In contrast to mammography, which compresses breast tissue and uses radiation, and MRI, which requires contrast injection and specialist radiologists, or handheld ultrasound conducted by a sonographer, a 3D ultrasound scanner uses sound waves to create a three-dimensional image, without compression, radiation, or contrast.

The scanning method is quite distinct from both mammography and traditional ultrasound. The patient lies face down on a padded table, placing one breast at a time into a tank of warm, chlorinated water. A ring of transducers then rotates around the breast, capturing coronal slices every two millimeters from the chest wall to the nipple, about 60 slices for an average-sized breast. The outcome is a fully reconstructed 3D image of the breast tissue. Misra notes, “The technologist doesn’t have to be a highly trained sonographer or mammographer.” In some centers, medical assistants perform this role, intentionally reducing reliance on operator expertise. The entire scan takes between 20 and 30 minutes and is validated for women from cup size A through triple D.

Does 3D Ultrasound Work? The Clinical Data Is Encouraging

While feasibility is key, accuracy is the ultimate measure of success. QT Imaging’s strategy focuses on clinical validation, and their early results are drawing attention, though a complete picture is still developing.

A preliminary head-to-head study with Mayo Clinic revealed that QT Imaging’s scanner detected every finding identified by MRI, according to Dinu. In one case, MRI classified a patient as BI-RADS 4 (suspicious), while the QT scan rated her BI-RADS 3 (probably benign), with a biopsy later confirming the QT result. “We are going to get fewer women to unnecessary biopsies,” states Dinu, though she acknowledges that larger samples are needed to ensure accurate conclusions about false positives.

Initial results also indicate that the technology may offer features distinct from MRI. The speed-of-sound imaging by QT can detect calcifications, which MRI often misses, and accurately differentiates cysts from solid masses. Additionally, the scanner can calculate breast density automatically, eliminating the need for third-party processing required in mammography.

Another potential advantage is its use as a surveillance tool. Due to the absence of radiation or contrast agents, QT can be repeated frequently and safely. Ongoing research at Toronto’s Sunnybrook Health Sciences Centre is investigating its application in monitoring tumor response in chemotherapy patients, a scenario where repeated MRIs or mammograms could pose concerns about cumulative contrast or radiation exposure. This research, along with the Mayo Clinic work, is still underway.

Studies with Mayo Clinic and Sunnybrook are ongoing, with Stanford next on the list. While early results are promising, they are based on limited sample sizes, and peer-reviewed publication is essential for broader validation. “We keep comparing ourselves head-to-head with MRI and showing again and again that the sensitivity and specificity are there,” says Dinu. “There is no shortcut. We have to keep showing.”

Getting a QT Scan: What Patients Need to Know

As with many new technologies, availability and cost are significant factors. Currently, QT imaging is seen by Dinu and Misra as a supplement to the gold standard mammogram. They stress that QT imaging should not replace a screening mammogram but rather serve as an additional tool, especially for those with dense breast tissue.

Women interested in a QT scan will find the process straightforward compared to other imaging methods. No physician referral is needed — patients can book directly at company-operated centers. For women navigating a complex screening landscape, the ability to self-refer is a valuable option.

The primary barrier at present is cost. Scans cost between $600 and $700 out of pocket, with insurance not yet covering the procedure. This expense, if it persists, could widen screening gaps, particularly for lower-income and under-resourced communities. However, Misra notes that QT Imaging has secured a Category III reimbursement code — the first step towards full insurance coverage — effective January 1, 2027.

“It’s a process,” says Misra, but the company plans to collaborate with payers to advocate for fair reimbursement rates. Category III codes serve as tracking mechanisms, enabling insurers to monitor usage before committing to full coverage; once a threshold is reached, the code can be upgraded to Category I — the standard for established, routinely reimbursed procedures.

For the time being, QT is an out-of-pocket option for women who can afford it and seek a more comprehensive understanding of their breast health.