TY - JOUR
T1 - ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density
AU - Expert Panel on Breast Imaging
AU - Weinstein, Susan P.
AU - Slanetz, Priscilla J.
AU - Lewin, Alana A.
AU - Battaglia, Tracy
AU - Chagpar, Anees B.
AU - Dayaratna, Sandra
AU - Dibble, Elizabeth H.
AU - Goel, Mita Sanghavi
AU - Hayward, Jessica H.
AU - Kubicky, Charlotte D.
AU - Le-Petross, Huong T.
AU - Newell, Mary S.
AU - Sanford, Matthew F.
AU - Scheel, John R.
AU - Vincoff, Nina S.
AU - Yao, Katherine
AU - Moy, Linda
N1 - Publisher Copyright:
© 2021 American College of Radiology
PY - 2021/11
Y1 - 2021/11
N2 - Mammography remains the only validated screening tool for breast cancer, however, there are limitations to mammography. One of the limitations of mammography is the variable sensitivity based on breast density. Supplemental screening may be considered based on the patient's risk level and breast density. For average-risk women with nondense breasts, the sensitivity of digital breast tomosynthesis (DBT) screening is high; additional supplemental screening is not warranted in this population. For average-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhanced mammography, screening ultrasound (US), breast MRI, or abbreviated breast MRI. In intermediate-risk women, there is emerging evidence suggesting that women in this population may benefit from breast MRI or abbreviated breast MRI. In intermediate-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhancedmammography or screening US. There is strong evidence supporting screening high-risk women with breast MRI regardless of breast density. Contrast-enhanced mammography, whole breast screening US, or abbreviated breast MRI may be also considered. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - Mammography remains the only validated screening tool for breast cancer, however, there are limitations to mammography. One of the limitations of mammography is the variable sensitivity based on breast density. Supplemental screening may be considered based on the patient's risk level and breast density. For average-risk women with nondense breasts, the sensitivity of digital breast tomosynthesis (DBT) screening is high; additional supplemental screening is not warranted in this population. For average-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhanced mammography, screening ultrasound (US), breast MRI, or abbreviated breast MRI. In intermediate-risk women, there is emerging evidence suggesting that women in this population may benefit from breast MRI or abbreviated breast MRI. In intermediate-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhancedmammography or screening US. There is strong evidence supporting screening high-risk women with breast MRI regardless of breast density. Contrast-enhanced mammography, whole breast screening US, or abbreviated breast MRI may be also considered. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - AU
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Breast MRI
KW - Breast MRI abbreviated
KW - Breast ultrasound
KW - Digital breast tomosynthesis
KW - Mammography with IV contrast
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U2 - 10.1016/j.jacr.2021.09.002
DO - 10.1016/j.jacr.2021.09.002
M3 - Article
C2 - 34794600
AN - SCOPUS:85119049296
SN - 1546-1440
VL - 18
SP - S456-S473
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 11
ER -