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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