At the time of this writing, the American Cancer Society is currently re-reviewing the literature regarding intermediate-risk women; however, its current stance, last updated in 2007, states there is insufficient evidence to formulate a recommendation in this group [15]. As of 2018, ACR recommends annual surveillance MRI in women with dense breasts and a personal history of breast cancer as well as in women who were diagnosed before age 50 [43]. The ACR suggests that MRI should be considered in the following categories: in women with personal histories of breast cancer and who do not fit the 2 previously stated categories and in women with atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ [43]. Supplemental Screening Based on Breast Density FDG-PET Breast Dedicated There is limited relevant literature regarding the use of FDG-PET breast dedicated for supplemental screening in intermediate-risk women with nondense breasts. This is not currently widely used in clinical practice. Sestamibi MBI There is limited relevant literature regarding the use of Tc-99m sestamibi MBI for supplemental screening in intermediate-risk women with nondense breasts. This is not currently widely used in clinical practice. In addition to the increase in the CDR, another benefit of adding DBT to 2-D mammography is the reduction in the recall rate [16-19]. In a single-center screening program, Sharpe et al [18] reported a reduction in the recall rate by 18.8%. In the prospective Oslo Tomosynthesis Screening Trial, the recall rate was reduced from 6.7/1,000 to 3.6/1,000 [19]. There is also evidence that the reduction in the recall rate is maintained over consecutive screening episodes [18]. Cortesi et al [35] evaluated the efficacy of biannual screening US examination in women who were BRCA mutation carriers, high-risk (non-BRCA1/2), and intermediate-risk patients.
Supplemental Breast Cancer Screening Based on Breast Density. At the time of this writing, the American Cancer Society is currently re-reviewing the literature regarding intermediate-risk women; however, its current stance, last updated in 2007, states there is insufficient evidence to formulate a recommendation in this group [15]. As of 2018, ACR recommends annual surveillance MRI in women with dense breasts and a personal history of breast cancer as well as in women who were diagnosed before age 50 [43]. The ACR suggests that MRI should be considered in the following categories: in women with personal histories of breast cancer and who do not fit the 2 previously stated categories and in women with atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ [43]. Supplemental Screening Based on Breast Density FDG-PET Breast Dedicated There is limited relevant literature regarding the use of FDG-PET breast dedicated for supplemental screening in intermediate-risk women with nondense breasts. This is not currently widely used in clinical practice. Sestamibi MBI There is limited relevant literature regarding the use of Tc-99m sestamibi MBI for supplemental screening in intermediate-risk women with nondense breasts. This is not currently widely used in clinical practice. In addition to the increase in the CDR, another benefit of adding DBT to 2-D mammography is the reduction in the recall rate [16-19]. In a single-center screening program, Sharpe et al [18] reported a reduction in the recall rate by 18.8%. In the prospective Oslo Tomosynthesis Screening Trial, the recall rate was reduced from 6.7/1,000 to 3.6/1,000 [19]. There is also evidence that the reduction in the recall rate is maintained over consecutive screening episodes [18]. Cortesi et al [35] evaluated the efficacy of biannual screening US examination in women who were BRCA mutation carriers, high-risk (non-BRCA1/2), and intermediate-risk patients.