[Comment] Breast cancer screening at a crossroads: supplemental imaging for dense breasts

Population breast cancer screening using mammography, alongside effective treatment, has been shown to reduce breast cancer mortality.1–3 Driven by concerns about suboptimal mammography sensitivity in women with mammographically-dense breasts,4,5 and by advocacy leading to legislated breast density notification in the USA,6 research efforts have increasingly focused on supplemental imaging for management of women with dense breasts.4,5,7 Although supplemental MRI or ultrasound screening has been shown to increase breast cancer detection in women with dense breasts and negative mammograms, it also adds false-positive results and unnecessary intervention.