Supplemental Screening for Women with Dense Breasts: What Do Practicing Radiologists Recommend?

To evaluate radiologists' supplemental screening recommendations for women with dense breasts, at average, intermediate, or high risk of breast cancer, and to determine if there are differences between their recommendations for their patients, their friends and family, and themselves.

This is an anonymous survey of Society of Breast Imaging (SBI) members. Demographics, knowledge of breast density as a risk factor, and recommendations for screening with digital breast tomosynthesis (DBT), ultrasound (US), and magnetic resonance imaging (MRI) in women with dense breasts, at average, intermediate, or high- risk of breast cancer were assessed. The likelihood of their recommending the screening test for their patients, their family and friends, and themselves was assessed on a Likert scale from 0 to 4 (0 = "not at all likely" to 4 = "extremely likely").

There were 295 responses: 67% were women, and breast imaging comprised 95% of their practice. Among participants, 53% correctly answered the question on relative risk of breast cancer when comparing extremely dense versus fatty breasts, and 57% when comparing heterogeneously dense versus scattered breasts. US is recommended at a relatively low rate (1.0-1.4 on the 0-4 scale), regardless of risk. DBT is recommended at a relatively high rate (2.5-3.0 on the 0-4 scale), regardless of risk status. MR is recommended mainly for those at high risk (3.6 on the 0-4 scale). Radiologists were more likely to recommend additional imaging for themselves than for their patients and their family and friends.

For women with dense breasts, radiologists are "somewhat likely" to recommend US and "likely" to "very likely" to recommend DBT regardless of risk group. They are "very likely" to recommend MRI for high-risk groups.