Guidance on supplemental breast cancer screening for women with dense breast tissue

Breast cancer is the second most common cause of cancer death in women. Although 1 in 8 women will be affected by breast cancer, early detection leads to improved survival.

"One challenge for some women is dense breast tissue," says author Suneela Vegunta, M.D., a women's health specialist at Mayo Clinic. Dr. Vegunta says there are millions of women in the U.S. with dense breast tissue. It's found in nearly half of women eligible for breast cancer screening, particularly in younger women. She says breast density may decrease after menopause.

"Dense breast tissue is an independent risk factor for breast cancer and may also mask small breast cancers, thereby reducing the sensitivity of a screening mammogram," says Dr. Vegunta.

She says that since legislation requiring providers to notify women about breast density was passed in several states, more women are aware of their breast density and are reaching out to health care professionals with questions.

"Supplemental breast cancer screening modalities can help diagnose additional cancers that are possibly masked by dense breast tissue on mammograms," says Dr. Vegunta. "Our paper provides information and guidance for health care professionals and patients on the benefits and drawbacks of various supplemental screening modalities in the background of using a risk-based stratification of patients with dense breast tissue."

Dr. Vegunta says that dense breast tissue is only one risk factor for breast cancer. If a patient has additional risk factors, such as family history of breast cancer, experienced early menstruation, has not given birth to a child, or has a prior history of abnormal breast biopsies, she should discuss enhanced surveillance with her health care provider.

Dr. Vegunta says consensus-based guidelines are not available related to screening women with dense breast tissue. Also, randomized controlled studies have not been performed that review the effect of supplemental screening versus mammography alone on breast cancer mortality. She says these studies, along with guidelines for screening women with dense breast tissue, are needed.