Breast Screening - Risk Adaptive Imaging for Density (BRAID)
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ClinicalTrials.gov Identifier: NCT04097366 |
Recruitment Status :
Recruiting
First Posted : September 20, 2019
Last Update Posted : November 23, 2022
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Condition or disease | Intervention/treatment | Phase |
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Breast Cancer | Diagnostic Test: ABUS Diagnostic Test: CESM Diagnostic Test: ABB-MRI | Not Applicable |
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 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 (CESM). 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.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 13200 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Diagnostic |
Official Title: | Breast Screening - Risk Adaptive Imaging for Density |
Actual Study Start Date : | May 28, 2019 |
Estimated Primary Completion Date : | March 31, 2023 |
Estimated Study Completion Date : | October 31, 2026 |

Arm | Intervention/treatment |
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No Intervention: Standard of Care
Control arm, no supplementary imaging is given. Participants have mammographic screening 3-yearly as per current standard of are.
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Active Comparator: Abbreviated MRI (ABB-MRI)
Supplementary imaging with abbreviated MRI at study entry and 18 months after baseline mammogram.
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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.
Other Names:
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Active Comparator: Automated Breast Ultrasound (ABUS)
Supplementary imaging with automated breast ultrasound at study entry and 18 months after baseline mammogram.
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Diagnostic Test: 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.
Other Names:
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Active Comparator: Contrast Enhanced Mammography (CESM)
Supplementary imaging with contrast enhanced spectral mammography at study entry and 18 months after baseline mammogram.
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Diagnostic Test: CESM
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.
Other Names:
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- Cancer detection rate in each arm [ Time Frame: 42 months after mammogram at study entry ]All cancers (detected or interval) in each arm over a three year period will be collected.
- Incidence of stage II or worse cancers over the period of observation [ Time Frame: 42 months after last participant entered ]size, lymph node status, metastatic status
- The sensitivity and specificity of supplemental imaging with ABB-MRI, CESM and ABUS with standard 2D FFDM. [ Time Frame: 6 months after mammogram at study entry ]Analysis will include: Detection rate of all breast cancers, Detection rate of all breast cancers by stage; Detection rate of all breast cancers by biological type; Detection rate of all breast cancers by size; Recall rates at prevalent round
- The sensitivity and specificity of supplemental imaging with ABB-MRI, CESM and ABUS with standard 2D FFDM. [ Time Frame: 21 months after mammogram at study entry ]Analysis will include: Detection rate of all breast cancers, Detection rate of all breast cancers by stage; Detection rate of all breast cancers by biological type; Detection rate of all breast cancers by size; Recall rates
- The sensitivity and specificity of supplemental imaging with ABB-MRI, CESM and ABUS with standard 2D FFDM. [ Time Frame: 42 months after last participant entered ]Analysis will include: Detection rate of all breast cancers, Detection rate of all breast cancers by stage; Detection rate of all breast cancers by biological type; Detection rate of all breast cancers by size; Recall rates at incident round; Interval cancer rate; Stage of interval cancers; Size of interval cancers
- Reading time of each examination [ Time Frame: 1 year ]Average time and range for each modality. (Seconds).
- Automated breast density measurements compared with reader assessment [ Time Frame: Baseline ]Percentage density.
- The risk of developing breast cancer as assessed by the BOADICEA model [ Time Frame: 72 months After last participant entered ]Percentage 5 year risk, percentage lifetime risk.

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Ages Eligible for Study: | 50 Years to 70 Years (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
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
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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

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04097366
Contact: Fiona Gilbert | 01223746439 | fjg28@medschl.cam.ac.uk | |
Contact: Jaimie Taylor | 01223746445 | jst50@medscl.cam.ac.uk |
United Kingdom | |
University Hospitals of Leicester, Leicester Royal Infirmary | Recruiting |
Leicester, Leicestershire, United Kingdom, LE1 5WW | |
Contact: Reena Aggarwal reena.aggarwal@uhl-tr.nhs.uk | |
Principal Investigator: Reena Aggarwal | |
Nottingham University Hospitals NHS Trust, City Hospital | Recruiting |
Nottingham, Nottinghamshire, United Kingdom, NG5 1PB | |
Contact: Jonathan James jonathan.james@nuh.nhs.uk | |
Principal Investigator: Jonathan James | |
Cambridge University Hospitals NHS Foundation Trust | Recruiting |
Cambridge, United Kingdom, CB2 0QQ | |
Contact: Fiona Gilbert 01223746439 fjg28@medschl.cam.ac.uk | |
Principal Investigator: Fiona Gilbert | |
Gloucestershire Hospitals NHS Foundation Trust | Not yet recruiting |
Cheltenham, United Kingdom, GL53 7AS | |
Contact: Sarah Vinnicombe sarah.vinnicombe@nhs.net | |
Principal Investigator: Sarah Vinnicombe | |
Tayside Health Board, Ninewells Hospital | Recruiting |
Dundee, United Kingdom, DD1 9SY | |
Contact: Sarah Savaridas sarah.savaridas@nhs.scot | |
Principal Investigator: Sarah Savaridas | |
Greater Glasgow Health Board, Gartnavel Royal Hospital | Recruiting |
Glasgow, United Kingdom, G12 0XH | |
Contact: Archana Seth archana.seth@ggc.scot.nhs.uk | |
Principal Investigator: Archana Seth | |
The Leeds Teaching Hospitals NHS Trust | Not yet recruiting |
Leeds, United Kingdom, LS9 7TF | |
Contact: Nisha Sharma nisha.sharma2@nhs.net | |
Principal Investigator: Nisha Sharma | |
Barts Health NHS Trust, Royal London Hospital | Recruiting |
London, United Kingdom, E1 1FR | |
Contact: Tamara Suaris t.suaris@nhs.net | |
Principal Investigator: Tamara Suaris | |
Royal Free London NHS Foundation Trust | Recruiting |
London, United Kingdom, NW3 2QG | |
Contact: William Teh william.teh@nhs.net | |
Principal Investigator: William Teh | |
Manchester University NHS Foundation Trust | Not yet recruiting |
Manchester, United Kingdom, M23 9LT | |
Contact: Anthony Maxwell anthony.maxwell@manchester.ac.uk | |
Principal Investigator: Anthony Maxwell |
Principal Investigator: | Fiona Gilbert | University of Cambridge |
Responsible Party: | Fiona J Gilbert, Professor of Radiology and Head of Department, University of Cambridge |
ClinicalTrials.gov Identifier: | NCT04097366 |
Other Study ID Numbers: |
A095053 |
First Posted: | September 20, 2019 Key Record Dates |
Last Update Posted: | November 23, 2022 |
Last Verified: | November 2022 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |