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. MRI Breast Without IV Contrast There is no relevant literature to support the use of MRI without IV contrast for screening women at average risk. MRI Breast Without IV Contrast Abbreviated There is no relevant literature to support the use of abbreviated MRI without IV contrast for screening women at average risk. Sestamibi MBI Data are limited regarding the use of sestamibi molecular breast imaging (MBI) for screening women at average risk. Most studies have focused upon women with dense breasts and variable risk profiles. One of the larger studies published to date of 1,696 women with recent negative or benign mammographic examinations showed that sestamibi MBI yielded an incremental CDR of 7.7 cancers per 1,000 examinations; however, all 13 cancers were detected in women with dense breasts [46]. Although 92% of the women within the study had <20% estimated lifetime risk, the estimates ranged from 6.1% to 17.2% [46]. Additional retrospective and prospective studies have demonstrated similar incremental CDR for sestamibi MBI of 6.5 to 9 per 1,000 over mammography [40,47]. Female Breast Cancer Screening Sestamibi MBI demonstrates similar sensitivity, better specificity, and lower recall rate compared to supplemental screening US in women with dense breasts [47,48]. US Breast Most studies evaluating the utility of screening with breast US have focused on women with dense breast tissue with or without other risk factors. Dense breast tissue decreases the sensitivity of mammography [26] and is an independent risk factor for developing breast cancer [27].
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. MRI Breast Without IV Contrast There is no relevant literature to support the use of MRI without IV contrast for screening women at average risk. MRI Breast Without IV Contrast Abbreviated There is no relevant literature to support the use of abbreviated MRI without IV contrast for screening women at average risk. Sestamibi MBI Data are limited regarding the use of sestamibi molecular breast imaging (MBI) for screening women at average risk. Most studies have focused upon women with dense breasts and variable risk profiles. One of the larger studies published to date of 1,696 women with recent negative or benign mammographic examinations showed that sestamibi MBI yielded an incremental CDR of 7.7 cancers per 1,000 examinations; however, all 13 cancers were detected in women with dense breasts [46]. Although 92% of the women within the study had <20% estimated lifetime risk, the estimates ranged from 6.1% to 17.2% [46]. Additional retrospective and prospective studies have demonstrated similar incremental CDR for sestamibi MBI of 6.5 to 9 per 1,000 over mammography [40,47]. Female Breast Cancer Screening Sestamibi MBI demonstrates similar sensitivity, better specificity, and lower recall rate compared to supplemental screening US in women with dense breasts [47,48]. US Breast Most studies evaluating the utility of screening with breast US have focused on women with dense breast tissue with or without other risk factors. Dense breast tissue decreases the sensitivity of mammography [26] and is an independent risk factor for developing breast cancer [27].