High mammographic breast density and its implications for the early detection of breast cancer

Objectives-Women with high mammographic breast density are at increased ris k of breast cancer. This study explores whether these women should receive intensified screening (more frequent screening or screening with alternativ e techniques that increase the length of the preclinical detectable phase) to reduce further breast cancer mortality. Methods-Mathematical models were used to estimate the effects of intensifie d screening in women with high breast density. The effects were expressed a s a reduction in the number of interval cancers. Results-If women with >25% breast density (comprising about one fifth of al l women) are screened annually instead of biennially, an 18% reduction in t he total number of interval cancers can be expected. Screening these women with alternative screening techniques biennially may produce the same reduc tion, provided that these techniques double the mean lead time. Conclusions-By screening women with dense breasts more intensively, many mo re breast cancers can theoretically be detected at an early stage. The resu lts provide an early indication of what may be expected from screening stra tegies. Next, cost-benefit analyses are needed.