Radio diagnosis

The study find that the Breast-density notification combined with breast-cancer risk helps identify women at high risk of advanced breast cancer who might benefit from supplemental imaging, according to an analysis of Breast Cancer Surveillance Consortium (BCSC) registry data. Therefore “Discussions of supplemental imaging in women with dense breasts should be combined with evaluating breast-cancer risk, given 50% of women with dense breasts are at low breast-cancer risk,” said Dr. Karla Kerlikowske of the University of California, San Francisco, and the Department of Veterans Affairs, San Francisco.

Supplemental imaging in women

“Providing information on breast density alone without; considering breast-cancer risk does not allow for the most informed clinical decisions to be made about appropriate use of supplemental imaging;” Because she told Reuters Health by email. Supplemental screening for breast cancer might benefit women with dense breasts who are at increased risk of interval and advanced breast cancer; and most states now require some level of notification on screening mammography reports of breast density.

The American College of Radiology suggests that supplemental ultrasonography may be useful in women with dense breasts as the only risk factor;but  while the U.S. Preventive Services Task Force has found insufficient evidence to assess the balance of benefits and harms of supplemental; screening in such women.

Supplemental ultrasonography

Dr. Kerlikowske’s team used data from more than 638,000 women in an effort to identify the most efficient strategy for targeting women for supplemental-imaging discussions. Therefore Women with dense breasts accounted for 47.0% of screened women and 60.0% of advanced cancers; the team reports in JAMA Internal Medicine, online July 1.

Higher advanced-cancer rates (0.61 or more cases per 1,000 mammograms; based on literature benchmarks); therefore were seen in 6.0% of screened women with heterogeneously dense breasts and a five-year BCSC cancer risk of 2.5% or higher and in 6.5% of screened women with extremely dense breasts and a five-year BCSC cancer risk of 1.0% or higher. Together; but these groups comprised 27.1% of advanced cancers.

The clinical impact

Women with any BI-RADS density and five-year BCSC risk less than 1.0% (which included 29.5% of screened women); had the lowest advanced-cancer rates and screen-detected early-cancer rates. Because Breast density plus BCSC five-year risk was the most accurate strategy (AUROC, 0.642); but for identifying women at risk of advanced breast cancer.

Using this combination strategy would result in 1,097 supplemental imaging discussions per potential advanced-cancer prevented; compared with 1,866 with supplemental imaging for all women with dense breasts. Therefore “Informing women of their specific breast-density category would allow women the opportunity to seek out published and online information about their specific density category; be better positioned to discuss the clinical impact of breast density on screening strategies; and make more informed choices with their healthcare providers;” she said.