Breast Density and the Importance of Supplemental Screening

Abstract

Mammographically dense breast tissue raises the risk of developing breast cancer and makes detection of breast cancer more difficult using standard of care mammography. This paper seeks to outline the evidence behind these risks and highlight the importance of informing patients, and their clinicians, of their density status. Solutions are also offered for improved detection in cancer screening in this population. Many states now require density information be conveyed to the patient. When performed in addition to screening mammography, supplemental screening methods (including tomosynthesis, ultrasound, and especially MRI) have demonstrated markedly improved rates of cancer detection in the dense screening population. However, only six states mandate insurance coverage for supplemental screening. Increased breast density inherently raises the risk of breast cancer and reduces mammographic sensitivity. It is essential that women with dense breasts are notified of these hazards and provided with additional screening methods to aid in early detection.