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

Area of Science:

• Radiology
• Breast Imaging
• Oncology

Background:

• Dense breast tissue is a significant risk factor for breast cancer.
• Supplemental screening modalities are crucial for early detection in women with dense breasts.
• Understanding radiologists' recommendations is key to optimizing screening protocols.

Purpose of the Study:

• To assess radiologists' recommendations for supplemental breast cancer screening in women with dense breasts.
• To evaluate differences in recommendations based on patient risk stratification (average, intermediate, high).
• To compare radiologists' recommendations for patients, family/friends, and themselves.

Main Methods:

• Anonymous survey distributed to Society of Breast Imaging (SBI) members.
• Assessed knowledge of breast density as a risk factor.
• Evaluated likelihood of recommending digital breast tomosynthesis (DBT), ultrasound (US), and magnetic resonance imaging (MRI) on a Likert scale.
• Collected data on radiologists' demographics and practice focus.

Main Results:

• 53-57% of radiologists correctly identified relative risk associated with dense breasts.
• Ultrasound (US) was recommended at low rates (1.0-1.4) across all risk groups.
• Digital breast tomosynthesis (DBT) received high recommendation rates (2.5-3.0) irrespective of risk.
• Magnetic resonance imaging (MRI) was primarily recommended for high-risk individuals (3.6).
• Radiologists were more inclined to recommend additional imaging for themselves compared to patients or loved ones.

Conclusions:

• Radiologists are "somewhat likely" to recommend US and "likely" to "very likely" to recommend DBT for women with dense breasts, regardless of risk.
• "Very likely" recommendation rates for MRI were observed for high-risk groups.
• A discrepancy exists between radiologists' personal screening recommendations and those for their patients/loved ones.