Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes.

No abstract

Breast density is associated with reduced mammographic sensitivity and specificity. Additionally, increased tumor size and worsened prognosis are associated with increased breast density. 1,2 Dense breast tissue may also represent an independent risk factor for breast cancer. 3 Currently, 24 states have laws mandating that women be notified of the implications of breast density, thereby encouraging discussions between patients and physicians regarding the need for supplemental screening. 4 However, which, if any, additional modalities should be recommended for women with dense breasts is not known. Using data from our previous multicenter study, 5 we evaluated differential screening performance of digital mammography combined with tomosynthesis compared with digital mammography alone as a function of breast density.

Three-dimensional RODEO MR imaging can be an adjunct to mammography because of its ability to enable better determination of tumor extent and differentiation of pure DCIS from DCIS with an invasive component.

D igital breast tomosynthesis (DBT) has been shown to improve screening performance by increasing cancer detection and decreasing the number of false-positive findings compared with screening with digital mammography (DM) alone (1-9). However, questions remain regarding whether the improvement in cancer detection is due to greater detection of slower-growing well-differentiated cancers that tend to have better prognosis and little impact on long-term outcomes, such as breast cancer-specific mortality (6). Symptomatic false-negative (FN) cancers, also known as interval cancers, manifest after a negative screening and before the next routine screening, with symptoms such as a palpable lump, pain, or nipple discharge. Symptomatic FN cancers tend to have worse outcomes owing to rapid growth rates and aggressive biologic types compared with screendetected cancers (10). Thus, a reduction in symptomatic FN cancers may be considered a surrogate for longer-term screening outcomes, such as morbidity and mortality (11). FN rates can be confounded by an additional group of cancers called asymptomatic FN cancers, which are detected by means of other imaging modalities between mammographic screens. Owing to legislation in the United States related to notification regarding dense breasts, more patients are