Supplemental Screening Modalities for People With Dense Breasts

CADTH has contributed to a collaborative health technology assessment with Ontario Health to support decision-making on the funding of supplemental screening for breast cancer in people with dense breasts. Screening for breast cancer looks for the disease before any symptoms appear so it can be caught and treated early. Many factors affect a person’s risk for breast cancer, including age, a strong family history of the disease, and breast density. Variations in breast density are normal and common, but higher breast density increases the risk of cancer and makes it harder to see cancers on a mammogram (a 2-dimensional breast X-ray).  

One way to improve cancer detection for people with dense breasts might be to use other types of imaging in addition to mammography (called supplemental screening). Types of breast imaging that could be added include contrast-enhanced mammography, ultrasound, digital breast tomosynthesis (3-dimensional breast X-ray), or MRI. 

This health technology assessment examined how accurate, safe, effective, and cost-effective supplemental screening is for people with dense breasts. It also looked at the budget impact of publicly funding supplemental screening; the experiences, preferences, understandings, and values of people with dense breasts and their health care providers; and ethical issues related to supplemental screening for people with dense breasts.