Kerlikowske et al showed in their recent study that breast density status should not be used as a stand-alone risk factor to refer women for supplemental imaging discussions. The researchers found that a combined approach using both BI-RADS breast density and BCSC 5-year risk score would identify those women at the highest risk for advanced cancer. The study assessed 638,856 women aged 40 to 74 years. The participants had 1,693,163 screening digital mammograms taken at Breast Cancer Surveillance Consortium (BCSC) imaging facilities. Of the 638,856 women involved in the study, 47% of women had heterogeneously or extremely dense breasts, and 60% of the advanced cancers occurred in these women. High advanced breast cancer rates occurred in women with heterogeneously dense breasts and a 5-year BCSC risk of 2.5% or higher and women with extremely dense breasts and a 5-year risk of 1.0% or higher. Researchers suggest necessary caution in establishing wide implementation of supplemental screening for all women with dense breast tissue without considering other risk factors for breast cancer.
Source: JAMA Internal Medicine July 1, 2019. doi:10.1001/jamainternmed.2019.1758 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2737320