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Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164:279-296.
Oeffinger KC, Fontham ET, Etzioni R, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;314:1599-1614.
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Practice Bulletin Number 179: Breast cancer risk assessment and screening in average-risk women. Obstet Gynecol. 2017;130:e1-e16.
Monticciolo DL, Newell MS, Hendrick RE, et al. Breast cancer screening for average-risk women: recommendations from the ACR Commission on Breast Imaging. J Am Coll Radiol. 2017;14:1137-1143.
Monticciolo DL, Newell MS, Moy L, et al. Breast cancer screening in women at higher-than-average risk: recommendations from the ACR. J Am Coll Radiol. 2018;15:408-414.
Sickles EA, D'Orsi CJ, Bassett LW, et al. ACR BI-RADS^® Mammography. In: ACR BI-RADS^® Atlas, Breast Imaging Reporting and Data System. American College of Radiology; 2013.
Sprague BL, Kerlikowske K, Bowles EJA, et al. Trends in clinical breast density assessment from the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2019;111:629-632. 
Conant EF, Sprague BL, Kontos D. Beyond BI-RADS density: a call for quantification in the breast imaging clinic. Radiology. 2018;286:401-404.
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Nazari SS, Mukherjee P. An overview of mammographic density and its association with breast cancer. Breast Cancer. 2018;25:259-267. 
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Kyanko KA, Hoag J, Busch SH, et al. Dense breast notification laws, education, and women's awareness and knowledge of breast density: a nationally representative survey. J Gen Intern Med. 2020;35:1940-1945.
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del Carmen MG, Halpern EF, Kopans DB, et al. Mammographic breast density and race. AJR Am J Roentgenol. 2007;188:1147-1150.
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Ekpo EU, Brennan PC, Mello-Thoms C, et al. Relationship between breast density and selective estrogen-receptor modulators, aromatase inhibitors, physical activity, and diet: a systematic review. Integr Cancer Ther. 2016;15:127-144.
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Faculty

Emily F. Conant, MD

Division Chief, Breast Imaging
Vice Chair Faculty Development Radiology
Professor of Radiology, Department of Radiology
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Disclosures

Disclosure: Emily F. Conant, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Hologic; iCAD
Served as a speaker or a member of a speakers bureau for: Aunt Minnie; Hologic; iCAD
Received grants for clinical research from: Hologic; iCAD

Editors

Victoria Phoenix, BS

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Vickie Phoenix, BS, has disclosed no relevant financial relationships.

Tristin Abair, PhD

Senior Medical Writer, Medscape, LLC

Disclosures

Disclosure: Tristin Abair, PhD, has disclosed no relevant financial relationships

CME Reviewer

Esther Nyarko, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

CME / ABIM MOC

Breast MRI: Cancer Screening for Women With Increased Breast Density

Authors: Emily F. Conant, MD
CME / ABIM MOC Released: 5/21/2021
THIS ACTIVITY HAS EXPIRED
Valid for credit through: 5/21/2022

Start Activity

Target Audience and Goal Statement

This activity is intended for obstetrician gynecologists (Ob/Gyns), women's health specialists, primary care physicians (PCPs), and radiologists.

The goal of this activity is to educate healthcare providers on the current guidelines for screening patients at high risk for breast cancer and how to counsel high-risk patients about the pros and cons of breast cancer screening options.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Screening guidelines for patients with dense breasts and average risk
- Benefits of using magnetic resonance imaging (MRI) in breast cancer screening

Disclosures

Faculty

Emily F. Conant, MD

Division Chief, Breast Imaging
Vice Chair Faculty Development Radiology
Professor of Radiology, Department of Radiology
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania

Disclosures

Disclosure: Emily F. Conant, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Hologic; iCAD
Served as a speaker or a member of a speakers bureau for: Aunt Minnie; Hologic; iCAD
Received grants for clinical research from: Hologic; iCAD

Editors

Victoria Phoenix, BS

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Vickie Phoenix, BS, has disclosed no relevant financial relationships.

Tristin Abair, PhD

Senior Medical Writer, Medscape, LLC

Disclosures

Disclosure: Tristin Abair, PhD, has disclosed no relevant financial relationships

CME Reviewer

Esther Nyarko, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

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From Medscape Education Radiology

CME / ABIM MOC

Breast MRI: Cancer Screening for Women With Increased Breast Density

Authors: Emily F. Conant, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED

CME / ABIM MOC Released: 5/21/2021

Valid for credit through: 5/21/2022

processing....

Introduction

Carrie is a 46-year-old middle school teacher who recently had her first baseline breast cancer screening with digital mammography based on recommendations from her primary care physician. She subsequently received a letter indicating that no abnormalities were found by mammography and informing her that she had heterogeneously dense breast tissue, BI-RADS® density category C. The letter indicated that she should speak with her doctor regarding the effect of her breast density on breast cancer risk and optimal screening. She called her Ob/Gyn with several questions and a telemedicine visit was scheduled to address her questions and determine the appropriate next steps.

Dr Roberts: Hello Carrie, can you hear me okay?

Carrie: Hi Dr Roberts. Yes, I can see and hear you just fine.

Dr Roberts: Great. It's good to see you again, even if it's not in person. How are you doing?

Carrie: I'm good. Spring is a busy time for our family and at school, so I'm running to keep up with everything.

Dr Roberts: I understand and can certainly relate. Spring is definitely full of activity! My nurse told me that you called the office and had questions about the results of your screening mammogram. I felt like a video call would be best to give us time to discuss your questions and concerns.

Carrie: Absolutely, thank you for taking the time to speak with me. I got a letter in the mail after my mammogram and I am confused about what it means and what should happen next.

Dr Roberts: Before we discuss the letter, let's back up and discuss your history if that's okay?

Carrie: Yes, that's fine.

Dr Roberts: Do you have any history of cancer in your family?

Carrie: Yes, my grandmother on my father's side passed away from breast cancer when I was a little girl. My dad has also had some skin cancers removed from his face and arms. He told me they weren't melanoma, they were some sort of slow growing spots. I can't remember exactly what he called them.

Dr Roberts: Perhaps basal cell carcinomas?

Carrie: Yes, that's right. Basal cell carcinomas.

Dr Roberts: What about your grandmother? Do you know how old she was when she was diagnosed?

Carrie: No, I'm not sure how old she was. I would guess she was in her late 50s when she passed away. My father doesn't talk about it much.

Dr Roberts: Okay, I understand. Let's meet at a future time to get a more detailed family history and decide if the family history increases your risks of breast cancer. I looked at your mammogram and saw that no abnormalities were found.

Carrie: That's right. But I got a letter saying I have dense breasts and I'm not sure what that means.

Dr Roberts: That's correct, the radiologist classified your breast tissue as heterogeneously dense, which means some of the tissue is considered fatty and some is dense.

Carrie: I'm assuming I received that letter because my breast density is important. What does it mean specifically for me?

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The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Emily F. Conant, MD

Editors

Victoria Phoenix, BS

Tristin Abair, PhD

CME Reviewer

Esther Nyarko, PharmD

Peer Reviewer

CME / ABIM MOC

Breast MRI: Cancer Screening for Women With Increased Breast Density

Target Audience and Goal Statement

Disclosures

Faculty

Emily F. Conant, MD

Editors

Victoria Phoenix, BS

Tristin Abair, PhD

CME Reviewer

Esther Nyarko, PharmD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Breast MRI: Cancer Screening for Women With Increased Breast Density

Introduction