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Marrying Story with Science: The Impact of Outdated and Inconsistent Breast Cancer Screening Practices in Canada
Review

The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening

Department of Radiology, Faculty of Medicine, University of British Columbia, 505-750 West Broadway, Vancouver, BC V5Z 1H4, Canada
Curr. Oncol. 2022, 29(5), 3595-3636; https://doi.org/10.3390/curroncol29050291
Received: 27 March 2022 / Revised: 23 April 2022 / Accepted: 25 April 2022 / Published: 17 May 2022
(This article belongs to the Special Issue Breast Cancer Imaging and Therapy)
The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in randomized controlled trials (RCTs) conducted from the early 1960s to the mid 1990s. Panels that recommend breast cancer screening guidelines have traditionally relied on the old RCTs, which did not include considerations of breast density, race/ethnicity, current hormone therapy, and other risk factors. Women do not all benefit equally from mammography. Mortality reduction is significantly lower in women with dense breasts because normal dense tissue can mask cancers on mammograms. Moreover, women with dense breasts are known to be at increased risk. To provide equity, breast cancer screening guidelines should be created with the goal of maximizing mortality reduction and allowing less aggressive therapy, which may include decreasing the interval between screening mammograms and recommending consideration of supplemental screening for women with dense breasts. This review will address the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis, and discuss options for supplemental screening. View Full-Text
Keywords: mammography; breast ultrasound; breast density; breast cancer screening; interval cancer; mortality reduction; breast MRI; digital breast tomosynthesis; molecular breast imaging; contrast-enhanced mammography mammography; breast ultrasound; breast density; breast cancer screening; interval cancer; mortality reduction; breast MRI; digital breast tomosynthesis; molecular breast imaging; contrast-enhanced mammography
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MDPI and ACS Style

Gordon, P.B. The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening. Curr. Oncol. 2022, 29, 3595-3636. https://doi.org/10.3390/curroncol29050291

AMA Style

Gordon PB. The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening. Current Oncology. 2022; 29(5):3595-3636. https://doi.org/10.3390/curroncol29050291

Chicago/Turabian Style

Gordon, Paula B. 2022. "The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening" Current Oncology 29, no. 5: 3595-3636. https://doi.org/10.3390/curroncol29050291

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