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Identifying Women With Dense Breasts at High Risk for Interval Cancer FREE

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The full report is titled “Identifying Women With Dense Breasts at High Risk for Interval Cancer. A Cohort Study.” It is in the 19 May 2015 issue of Annals of Internal Medicine (volume 162, pages 673-681). The authors are K. Kerlikowske, W. Zhu, A.N.A. Tosteson, B.L. Sprague, J.A. Tice, C.D. Lehman, and D.L. Miglioretti, for the Breast Cancer Surveillance Consortium.

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Ann Intern Med. 2015;162(10):I-10. doi:10.7326/P15-9018
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What is the problem and what is known about it so far?

Having dense breasts is a risk factor for breast cancer and also makes it harder to find cancer on mammograms. Many states require doctors to tell women if their mam-mograms show dense breasts and to give advice about having more screening tests, such as breast ultrasonography. The extra screening tests may cause anxiety by showing something that ends up not being cancer.

Why did the researchers do this particular study?

To see whether breast cancer risk calculations along with different levels of breast density can identify women who have an increased risk for breast cancer after being told that their mammogram was normal.

Who was studied?

Women aged 40 to 74 years who had digital screening mammography and no history of breast implants or breast cancer.

How was the study done?

Investigators examined the relationships among different groupings of 5-year breast cancer risk and breast density levels and the chance of developing breast cancer after a normal mammogram.

What did the researchers find?

Almost half of women had mammograms that showed dense breasts. For most women who had a mammogram, the risk for breast cancer after a normal mam-mogram was low, even for those who had dense breasts and low 5-year breast cancer risk. Women who had extremely dense breasts or different patterns of breast density were most likely to have high or very high 5-year breast cancer risk. Two groups of women had the highest risk for breast cancer after a normal mammogram: those with extremely dense breasts and an intermediate or high 5-year cancer risk, and those who had different patterns of breast density and a high or very high 5-year cancer risk.

What were the limitations of the study?

The investigators were not able to tell whether discussions between providers and their patients about supplemental breast imaging would be helpful.

What are the implications of the study?

Not all women with dense breasts have a high enough risk for breast cancer after a normal mammogram to justify having more screening tests. This study showed that information on 5-year cancer risks could be used along with breast density levels to help providers focus on the women who should receive information about supplemental breast cancer screening tests.





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