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. Given the limitations of mammography and to minimize interval cancers, supplemental screening modalities have been investigated in women at average risk. Because screening mammography decreases breast cancer mortality, screening mammography or screening DBT is still performed in women undergoing supplemental screening studies [3,8,35]. Rather than supplementing screening mammography with additional imaging modalities, some have suggested limiting women offered screening mammography based upon individual patient risk assessed by various risk models, breast density, or genetic information such as single-nucleotide polymorphism. However, the randomized controlled trials demonstrating mortality reduction and most large-scale observational studies enrolled women based upon geographic location and age, not other individual patient risk factors. In one observational study in women <50 Female Breast Cancer Screening years of age, restricting screening to women with a first-degree family history, extremely dense breast tissue, or both, would cause 66% of potentially screen-detected cancers to be missed [41]. To maximize the benefits, the ACR recommends screening mammography in average-risk women each year beginning at 40 years of age. Women should continue screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified [5,8].
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. Given the limitations of mammography and to minimize interval cancers, supplemental screening modalities have been investigated in women at average risk. Because screening mammography decreases breast cancer mortality, screening mammography or screening DBT is still performed in women undergoing supplemental screening studies [3,8,35]. Rather than supplementing screening mammography with additional imaging modalities, some have suggested limiting women offered screening mammography based upon individual patient risk assessed by various risk models, breast density, or genetic information such as single-nucleotide polymorphism. However, the randomized controlled trials demonstrating mortality reduction and most large-scale observational studies enrolled women based upon geographic location and age, not other individual patient risk factors. In one observational study in women <50 Female Breast Cancer Screening years of age, restricting screening to women with a first-degree family history, extremely dense breast tissue, or both, would cause 66% of potentially screen-detected cancers to be missed [41]. To maximize the benefits, the ACR recommends screening mammography in average-risk women each year beginning at 40 years of age. Women should continue screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified [5,8].