CHICAGO—Screening for breast cancer with mammography saves lives, but researchers say new approaches offer the potential of more accuracy in identifying abnormalities. While mammography as it is performed now reduces mortality, it does not detect all cancers. It also identifies some benign abnormalities as possibly cancerous, causing unnecessary stress for women needing further assessment and increasing costs for retesting and interpretation. At the Scientific Sessions of the Radiological Society of North America (RSNA) held here in November, investigators presented findings on improvements to current mammography techniques and data on new mammography modalities that may improve sensitivity and specificity. According to the American Cancer Society, in the United States at least 211 240 women were diagnosed with invasive breast cancer and 40 410 died from the disease in 2005 (http: //www.cancer.org/downloads/STT /CAFF2005BrFacspdf2005.pdf). Screening mammography is estimated to result in a relative reduction in mortality of 20% to 35% for women aged 50 to 69 years and about 20% for women aged 40 to 49 years. Film mammography remains the most common screening tool for breast cancer. Gradually being adopted is digital mammography, which produces an electronic image that can be stored and transmitted by computer. Digital mammography is now offered in about 20% of US screening clinics, but so far it has been shown to be only slightly more sensitive than film mammography in detecting breast cancer but only in women younger than 50 years, women with radiographically dense breasts, and premenopausal women (Pisano ED et al. N Engl J Med. 2005;353[17]:17731783). Another new digital tool is computeraided detection, which serves as a second read for radiologists. But its efficacy was questioned in a recent study that found this method reduces the accuracy of interpreting results and increases the rate of biopsy (Fenton JJ et al. N Engl J Med. 2007;356[14]:13991409). However, other researchers believe that this study was flawed and are thus not dismissing computer-aided detection. Overall, researchers think they can do better. “In general, there’s been increasing awareness in the medical community that mammography misses a substantial number of cancers, especially in women with dense breasts,” said Wendie Berg, MD, PhD, a radiologist with American Radiology Services in Lutherville, Md, who presented findings on a study evaluating the addition of ultrasound to standard mammography at the RSNA meeting. “So there’s been interest in screening with a variety of techniques.”