nUniversity of Washington, Seattle, Washington. oDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. pNorthShore University HealthSystem, Evanston, Illinois; American College of Surgeons. qSpecialty Chair, NYU Clinical Cancer Center, New York, New York. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Supplemental Screening Based on Breast Density Discussion of Procedures by Variant Variant 1: Supplemental breast cancer screening. Average-risk females with nondense breasts. Mammography remains the only validated screening tool for breast cancer screening. Despite widespread mammographic screening, breast cancer represents the leading cause of cancer mortality in women. Although multiple studies have demonstrated improved survival and reduction in breast cancer mortality by up to 30% with regular mammographic screening, there continues to be approximately 40,000 breast cancer deaths annually [10- 13]. Women who have <15% lifetime risk are considered to be at average risk [15]. In women with nondense breast tissue, the sensitivity of mammography is high [5]. 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 Breast Cancer Screening Based on Breast Density. nUniversity of Washington, Seattle, Washington. oDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. pNorthShore University HealthSystem, Evanston, Illinois; American College of Surgeons. qSpecialty Chair, NYU Clinical Cancer Center, New York, New York. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Supplemental Screening Based on Breast Density Discussion of Procedures by Variant Variant 1: Supplemental breast cancer screening. Average-risk females with nondense breasts. Mammography remains the only validated screening tool for breast cancer screening. Despite widespread mammographic screening, breast cancer represents the leading cause of cancer mortality in women. Although multiple studies have demonstrated improved survival and reduction in breast cancer mortality by up to 30% with regular mammographic screening, there continues to be approximately 40,000 breast cancer deaths annually [10- 13]. Women who have <15% lifetime risk are considered to be at average risk [15]. In women with nondense breast tissue, the sensitivity of mammography is high [5]. 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].