The conundrum of breast density; guidance for healthcare providers

A finding of dense breasts on mammogram decreases the sensitivity of mammogram and increases a woman's risk of breast cancer. Supplemental screening can increase breast cancer detection in women with dense breasts, but caries a risk of increased false-positive test results. There are currently no clear guidelines for providers or patients on recommendations for supplemental screening after a mammogram finding of heterogeneously or extremely dense breasts on mammography. In addition, there is currently great variation in communication and management of breast density amongst physicians and other licensed providers. Women at higher risk for developing breast cancer would benefit most from supplemental screening. Standardizing recommendations and implementation of risk-based decision-making using a validated calculator would allow for earlier detection of breast cancer, clear guidance for providers, and ensure equitable care for patients.