Sestamibi MBI There is limited relevant literature regarding the use of Tc-99m sestamibi MBI for supplemental screening in average-risk women with nondense breasts. This is not currently widely used in clinical practice. Variant 2: Supplemental breast cancer screening. Intermediate-risk females with nondense breasts. Women at intermediate risk for breast cancer are defined as having a 15% to 20% lifetime risk [15]. Although there are clear screening guidelines for women with >20% lifetime risk, the screening guidelines have not clearly been defined for women who are at intermediate risk. Women in this category may include patients who have been diagnosed with lobular neoplasia, atypical ductal hyperplasia, previous history of breast cancer, or have a family history of breast cancer without known genetic mutations such as breast cancer gene (BRCA)1/2. 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]. Supplemental Screening Based on Breast Density In women with a personal history of breast cancer, the supplemental CDR of screening ultrasound (US) has been reported to be 2.88/1,000 [34]. There was no difference in the CDR based on breast density or age. However, the authors reported an interval cancer rate of 1.5/1,000, which was higher in women who were <50 years of age and in those with dense breast tissue, indicating the failure of screening US in these 2 subgroups.
Supplemental Breast Cancer Screening Based on Breast Density. Sestamibi MBI There is limited relevant literature regarding the use of Tc-99m sestamibi MBI for supplemental screening in average-risk women with nondense breasts. This is not currently widely used in clinical practice. Variant 2: Supplemental breast cancer screening. Intermediate-risk females with nondense breasts. Women at intermediate risk for breast cancer are defined as having a 15% to 20% lifetime risk [15]. Although there are clear screening guidelines for women with >20% lifetime risk, the screening guidelines have not clearly been defined for women who are at intermediate risk. Women in this category may include patients who have been diagnosed with lobular neoplasia, atypical ductal hyperplasia, previous history of breast cancer, or have a family history of breast cancer without known genetic mutations such as breast cancer gene (BRCA)1/2. 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]. Supplemental Screening Based on Breast Density In women with a personal history of breast cancer, the supplemental CDR of screening ultrasound (US) has been reported to be 2.88/1,000 [34]. There was no difference in the CDR based on breast density or age. However, the authors reported an interval cancer rate of 1.5/1,000, which was higher in women who were <50 years of age and in those with dense breast tissue, indicating the failure of screening US in these 2 subgroups.