Breast imaging market "better than average"

February 28, 2013
by Brendon Nafziger, DOTmed News Associate Editor
Nearly 600 U.S. breast imaging facilities have closed shop over the past decade, decelerating sales growth of X-ray mammography and other breast imaging equipment. But an uptick in cancer rates and state-level breast density legislation, which lead women to get supplemental ultrasound or MRI scans, could translate into a modest bump for the sector over the next five years, according to a new market research report.

"I think the positives, the drivers, really outweigh the restraints, which is why we have pretty moderate positive growth projections," analyst Roberto Aranibar, the author of a new Frost & Sullivan report on the breast imaging market, told DOTmed News.

In the report, released Wednesday, the firm predicts the four segments of the breast imaging market — X-ray mammography, breast MRI, breast ultrasound and molecular breast imaging — will grow from $1 billion in 2011 to $1.4 billion by 2016, for a compound annual growth rate of 5.8 percent.

Aranibar said although he doesn't project aggressive growth, this is "better than average" when compared with other medical imaging sectors.

Contraction

One of the hold-backs is a slight shrinkage in the number of breast imaging facilities. The number fell 7 percent from 2002 to 2011, contracting from 9,224 to 8,619, according to records kept by the federal government, which tracks certified X-ray mammography facilities. The install base for mammography equipment also shrank, dropping from 13,652 in 2003 to 12,292 in 2011, Aranibar said, citing federal records.

"I think it's just a broader trend in the market right now," he explained. "With health care there's a lot of consolidation."

The drop was greatest between 2002 and 2006, but the number of facilities stabilized from 2010 to 2012. According to the most recent data available on the FDA's website, in October 2010 there were 8,654 certified facilities.

The problem here is that mammography is a replacement market. Digital systems, a key upgrade, already represented 80 percent of the install base in 2011, according to the report.

"You don't have a lot of new adopters or new facilities opening up," Aranibar said. "With the number of facilities and install base shrinking, that translates into lower replacement revenues."

Density

Counteracting market contraction, though, is the spread of supplemental scanning technology, such as ultrasound, MRI and breast tomosynthesis.

A big driver for these is recently enacted breast density legislation. The first such breast density law was passed in Connecticut three years ago, and similar laws have since been adopted by four other states: California, New York, Texas and Virginia. Others, including Ohio, are also considering breast density bills.

While the laws vary, in general, they require that the mammography reports sent to women after a mammogram must inform the patient if she has dense breasts, and to suggest following up with her doctor.

Dense breast tissue appears white on a mammogram, which can mask cancer during screenings. Women with dense breasts are also thought to be at a higher risk of disease.

According to Are You Dense, an advocacy group that pushes for the laws, about 40 percent of women have dense breasts.

"I think that what's impacting the most, from what we've seen in Connecticut, is a major growth in supplemental breast ultrasound procedures being done," Aranibar said.

In the report, Frost & Sullivan said one Connecticut study found that after the density law went into effect, half of the 77,000 women informed of their breast density went in for a supplemental ultrasound scan. Also, new technologies are becoming more important. Last fall, U-Systems' automated breast ultrasound system became the first such product approved by the Food and Drug Administration to be used as an adjunct for screening women with dense breasts. (The company was bought by GE for an undisclosed amount in November.)

Figuring out the current market for breast ultrasound is tricky, however, as ultrasound is typically shared between departments. But Aranibar estimates that the market for ultrasounds sold with probes that enable breast imaging amounted to some $300 million in 2011.

He expects it to grow at a rate of 6.1 percent from 2011 to 2016, slightly outpacing X-ray mammography at 5.9 CAGR and even breast MRI, also a supplemental technique, at 5.1 percent.

"It's really an area that's gaining a lot of interest," he said.