Compared to average breast density (near the threshold between heterogeneously dense and scattered areas of fibroglandular density), the relative risks for developing breast cancer are 1.2 for heterogeneously dense and 2.1 for extremely dense breasts [28]. Some health care providers may therefore consider women with extremely dense breasts to no longer be average risk. Irrespective of risk category, meta-analyses have demonstrated an incremental increase in CDR of 1.6 to 3.2 per 1,000 screening DBT examinations and a 2.2% pooled decrease in recall rate compared to digital mammography [18,29,30]. The degree of breast cancer mortality reduction from screening mammography varies with different screening regimens. Mortality reduction is greater when screening begins at 40 years of age rather than 45 or 50 years of age Within the limited studies of women at elevated risk due to personal and/or family history of breast cancer, DBT decreased recall rate without a significant increase in CDR compared to FFDM; however, small sample sizes restrict analyses [3,40]. Because screening mammography decreases breast cancer mortality, screening mammography or screening DBT is still performed in women undergoing supplemental screening studies [3,8,35]. The ACR recommends annual screening mammography beginning no later than 40 years of age for women at intermediate risk [3]. For those with a family history of breast cancer, mammography should begin earlier if familial breast cancer occurred at a young age, typically 10 years prior to the youngest age at presentation but generally not before age 30 [6]. For women who have lobular neoplasia or atypical hyperplasia diagnosed prior to 40 years of age, annual screening mammography should be performed from time of diagnosis but generally not prior to 30 years of age [38].
Female Breast Cancer Screening. Compared to average breast density (near the threshold between heterogeneously dense and scattered areas of fibroglandular density), the relative risks for developing breast cancer are 1.2 for heterogeneously dense and 2.1 for extremely dense breasts [28]. Some health care providers may therefore consider women with extremely dense breasts to no longer be average risk. Irrespective of risk category, meta-analyses have demonstrated an incremental increase in CDR of 1.6 to 3.2 per 1,000 screening DBT examinations and a 2.2% pooled decrease in recall rate compared to digital mammography [18,29,30]. The degree of breast cancer mortality reduction from screening mammography varies with different screening regimens. Mortality reduction is greater when screening begins at 40 years of age rather than 45 or 50 years of age Within the limited studies of women at elevated risk due to personal and/or family history of breast cancer, DBT decreased recall rate without a significant increase in CDR compared to FFDM; however, small sample sizes restrict analyses [3,40]. Because screening mammography decreases breast cancer mortality, screening mammography or screening DBT is still performed in women undergoing supplemental screening studies [3,8,35]. The ACR recommends annual screening mammography beginning no later than 40 years of age for women at intermediate risk [3]. For those with a family history of breast cancer, mammography should begin earlier if familial breast cancer occurred at a young age, typically 10 years prior to the youngest age at presentation but generally not before age 30 [6]. For women who have lobular neoplasia or atypical hyperplasia diagnosed prior to 40 years of age, annual screening mammography should be performed from time of diagnosis but generally not prior to 30 years of age [38].