Don’t be dense.
The Study: The Breast Cancer Surveillance Consortium (BCSC) thinks it’s got the answer. While genetic testing is all the rage, the vast majority of women who develop breast cancer don’t have a known genetic cause. Drawing from the Washington state BCSC registry, data on >130K women was used to prospectively risk stratify patients using mammographic density in addition to clinical info. Incorporating breast density classified almost twice the number (n=4645, 3.5%) of women as high-risk compared to the classic clinical risk factors alone (n=2554, 1.9%). The proportions of “high-risk” women identified by each model who went on to develop breast cancer at a median of 5 years follow-up were the same (6%). The most dense breast category (BI-RADS D) carried a whopping 4-fold increase in risk of development of breast cancer compared to the least dense category (BI-RADS A). The cost of such a screening technique? Nothing more than an informed radiologist, making this strategy a popular one for future individualized recommendations regarding timing and frequency of screening.
Bottom Line: Breast density is an easy and effective way to risk stratify women being screened for breast cancer, and at no extra cost. | Brentnall, JAMA Oncol 2018