Breast Screening - Risk Adaptive Imaging for Density

NCT ID: NCT04097366

Last Updated: 2025-03-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

9000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-28

Study Completion Date

2025-10-31

Brief Summary

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BRAID is a randomised, multi-centre study assessing the impact of supplementary imaging in the detection of breast cancer in women participating in the UK national breast screening programme who have dense breast tissue.

Detailed Description

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Breast density is a measure of the amount of fibroglandular tissue and is a risk factor for breast cancer. Women with extremely dense breasts are at 4-fold increased breast cancer risk compared to women with 'fatty' breasts. High breast density reduces the sensitivity of mammography increasing the probability of the test missing a cancer. Women with dense breasts have their cancers found when the cancer is larger as they present with interval cancers or their cancers are not detected until the next screening round at a later stage.

The UK national breast screening programme (NHS BSP) offers all women aged 50-70 screening with 3-yearly mammograms. It aims to reduce breast cancer mortality by 20% by detecting small cancers thereby reducing the number of late stage diagnoses. However only 53% of the cancers being detected are small (\<15mm). This is partly due to masking of cancers by dense breast tissue.

This trial addresses how best to screen women with dense breasts for breast cancer. BRAID will randomise women whose recent screening normal mammogram shows that they have dense breasts to either standard of care (no supplementary imaging) or supplementary imaging with abbreviated MRI (ABB-MRI), automated whole breast ultrasound (ABUS) or contrast enhanced spectral mammography (CEM). These imaging techniques have been shown to be more sensitive than mammography at detecting cancers in dense breast tissue. Our hypothesis is that more cancers will be detected at an earlier stage with supplemental imaging.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Standard of Care

Control arm, no supplementary imaging is given. Participants have mammographic screening 3-yearly as per current standard of are.

Group Type NO_INTERVENTION

No interventions assigned to this group

Abbreviated MRI (ABB-MRI)

Supplementary imaging with abbreviated MRI at study entry and 18 months after baseline mammogram.

Group Type ACTIVE_COMPARATOR

ABB-MRI

Intervention Type DIAGNOSTIC_TEST

ABB-MRI is a shorter version of breast MRI. Standard T1W pre and post contrast images are acquired. A MIP and post-contrast T1 weighted image are read.

Automated Breast Ultrasound (ABUS)

Supplementary imaging with automated breast ultrasound at study entry and 18 months after baseline mammogram.

Group Type ACTIVE_COMPARATOR

ABUS

Intervention Type DIAGNOSTIC_TEST

Automated whole breast ultrasound (ABUS) is undertaken with a large transducer panel placed on the breast in three positions. Resultant images are combined to make a 3D image of the breast.

Contrast Enhanced Mammography (CEM)

Supplementary imaging with contrast enhanced spectral mammography at study entry and 18 months after baseline mammogram.

Group Type ACTIVE_COMPARATOR

CEM

Intervention Type DIAGNOSTIC_TEST

A high kV and a low kV image is taken in two standard views of each breast following the intravenous injection of an iodinated contrast agent.

Interventions

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ABUS

Automated whole breast ultrasound (ABUS) is undertaken with a large transducer panel placed on the breast in three positions. Resultant images are combined to make a 3D image of the breast.

Intervention Type DIAGNOSTIC_TEST

CEM

A high kV and a low kV image is taken in two standard views of each breast following the intravenous injection of an iodinated contrast agent.

Intervention Type DIAGNOSTIC_TEST

ABB-MRI

ABB-MRI is a shorter version of breast MRI. Standard T1W pre and post contrast images are acquired. A MIP and post-contrast T1 weighted image are read.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Whole Breast Ultrasound Automated Breast Ultrasound Contrast Enhanced Mammography Abbreviated Magnetic Resonance Imaging Abridged MRI Abbreviated Protocol MRI Abbreviated Breast MRII

Eligibility Criteria

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Inclusion Criteria

* Willing and able to give written informed consent
* Willing and able to comply with the scheduled study visits, tests and other procedures
* Female
* Screening mammogram that is either normal or being recalled for assessment
* Increased breast density identified on current screening mammogram examination (BIRADS C or D)

* If BIRADS C the reporting radiologist should use clinical judgement as to eligibility, there should be a high chance of a cancer being masked in this participant
* All BIRADS D will be eligible
* Aged 50-70 and eligible for 3-yearly NHS breast screening

Exclusion Criteria

* Known BRCA carrier or ≥50% risk of being a carrier
* Unable to give informed consent
* Breast implant(s)
* Unable to be followed-up for the study duration
* Current participation in another interventional breast screening trial (Including but not limited to MyPeBS)
* Participated in part A of the BRAID study
* Pregnant or breast feeding
Minimum Eligible Age

50 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Cancer Research UK

OTHER

Sponsor Role collaborator

GE Healthcare

INDUSTRY

Sponsor Role collaborator

Queen Mary University of London

OTHER

Sponsor Role collaborator

Public Health England

OTHER_GOV

Sponsor Role collaborator

University of Cambridge

OTHER

Sponsor Role lead

Responsible Party

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Fiona J Gilbert

Professor of Radiology and Head of Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fiona Gilbert

Role: PRINCIPAL_INVESTIGATOR

University of Cambridge

Locations

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Tayside Health Board, Ninewells Hospital

Dundee, Dundee, United Kingdom

Site Status

Greater Glasgow Health Board, Gartnavel Royal Hospital

Glasgow, Glasgow, United Kingdom

Site Status

University Hospitals of Leicester, Leicester Royal Infirmary

Leicester, Leicestershire, United Kingdom

Site Status

Barts Health NHS Trust, Royal London Hospital

London, London, United Kingdom

Site Status

Royal Free London NHS Foundation Trust

London, London, United Kingdom

Site Status

Nottingham University Hospitals NHS Trust, City Hospital

Nottingham, Nottinghamshire, United Kingdom

Site Status

Cambridge University Hospitals NHS Foundation Trust

Cambridge, , United Kingdom

Site Status

Gloucestershire Hospitals NHS Foundation Trust

Cheltenham, , United Kingdom

Site Status

The Leeds Teaching Hospitals NHS Trust

Leeds, , United Kingdom

Site Status

Manchester University NHS Foundation Trust

Manchester, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Gilbert FJ, Payne NR, Allajbeu I, Yit L, Vinnicombe S, Lyburn I, Sharma N, Teh W, James J, Seth A, Suaris T, Aggarwal R, Al-Attar M, Savaridas S, Antoniou A, Pharoah P, Duffy S. Comparison of supplemental breast cancer imaging techniques-interim results from the BRAID randomised controlled trial. Lancet. 2025 May 31;405(10493):1935-1944. doi: 10.1016/S0140-6736(25)00582-3. Epub 2025 May 21.

Reference Type DERIVED
PMID: 40412427 (View on PubMed)

Other Identifiers

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A095053

Identifier Type: -

Identifier Source: org_study_id

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