American College of Radiology Recommendations for Higher than Average Risk Includes Increased Breast Density

As research concludes that Early detection is a critical factor in reducing mortality, the American College of Radiology (ACR) published recommendations for higher than average risk women.  In this JACR publication, the subgroups at higher risk are recognized with specific recommendations for screening in each of the groups.

Models for risk assessment are also discussed including the Tyrer-Cuzick model which is the most consistently accurate model for predicting breast cancer risk.  The new version of the Tyrer-Cuzick included a patient's breast tissue composition in the calculations.

The recommendations for women with dense breasts include a yearly MRI for women with dense tissue and other risk factors such as personal histories of breast cancer and those diagnosed before 50.

For women with increased breast density alone, ultrasound can be considered for adjunctive screening, after weighing the benefits and risks.

Dr Jean Weigert's study on the Connecticut experience was referenced to demonstrate that the positive predictive value (less false positives - biopsies) increased from 7.3% in year 1 to 20.1% by year 4, demonstrating that false positives are greatly reduced, through practice and training in ultrasound as a screening technology.


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  • Are You Dense? Fact #1:

    Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.

  • Are You Dense? Fact #2:

    Two-thirds of pre-menopausal women and 40% of post-menopausal women have dense breast tissue. 

  • Are You Dense? Fact #3:

    Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.

  • Are You Dense? Fact #4:

    American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.

  • Are You Dense? Fact #5:

    While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with dense breasts.

  • Are You Dense? Fact #6:

    A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.

  • Are You Dense? Fact #7:

    Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.

  • Are You Dense? Fact #8:

    A substantial proportion of Breast Cancer can be attributed to high breast density alone.

  • Are You Dense? Fact #9:

    Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.

  • Are You Dense? Fact #10

    There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.