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]. Screening breast US in women with mammographically dense breasts, including those with risk factors placing them at increased breast cancer risk, identifies predominantly mammographically occult, small, node-negative invasive tumors with an increased CDR of 1.8 to 4.6 cancers per 1,000 women screened [40,49]. Although supplemental screening US in women with dense breasts results in an increased CDR, US also increases recall rate, false-positive examinations, and false-positive biopsies [26,49-55]. In women undergoing annual mammography plus annual supplemental screening MRI, the addition of supplemental screening with US does not identify additional cancers and is therefore not routinely performed. The ACRIN 6666 trial enrolled women with dense breast tissue and at least one other breast cancer risk factor [61]. Compared to mammography alone, screening US detected 5.3 cancers per 1,000 in year 1, 3.7 cancers per 1,000 in years 2 and 3, and resulted in a larger number of false-positive examinations and false-positive biopsies each year [61]. In a prospective study limited to intermediate-risk women, sensitivity of mammography was 57%, US was 24.5%, and mammography combined with biannual US demonstrated 80.4% sensitivity [76]. In women with a Female Breast Cancer Screening personal history of breast cancer, supplemental US screening results in an incremental CDR of 2.4 to 2.9 cancers per 1,000 examinations over mammography alone; however, US screening has lower specificity [10,66].
Female Breast Cancer Screening. 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]. Screening breast US in women with mammographically dense breasts, including those with risk factors placing them at increased breast cancer risk, identifies predominantly mammographically occult, small, node-negative invasive tumors with an increased CDR of 1.8 to 4.6 cancers per 1,000 women screened [40,49]. Although supplemental screening US in women with dense breasts results in an increased CDR, US also increases recall rate, false-positive examinations, and false-positive biopsies [26,49-55]. In women undergoing annual mammography plus annual supplemental screening MRI, the addition of supplemental screening with US does not identify additional cancers and is therefore not routinely performed. The ACRIN 6666 trial enrolled women with dense breast tissue and at least one other breast cancer risk factor [61]. Compared to mammography alone, screening US detected 5.3 cancers per 1,000 in year 1, 3.7 cancers per 1,000 in years 2 and 3, and resulted in a larger number of false-positive examinations and false-positive biopsies each year [61]. In a prospective study limited to intermediate-risk women, sensitivity of mammography was 57%, US was 24.5%, and mammography combined with biannual US demonstrated 80.4% sensitivity [76]. In women with a Female Breast Cancer Screening personal history of breast cancer, supplemental US screening results in an incremental CDR of 2.4 to 2.9 cancers per 1,000 examinations over mammography alone; however, US screening has lower specificity [10,66].