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July 18, 2012

Supplementary Imaging for Breast Cancer Screening in High-Risk Women

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliation: Jikei University of School of Medicine, Tokyo, Japan (tetsu@jg8.so-net.ne.jp).

JAMA. 2012;308(3):236. doi:10.1001/jama.2012.7545

To the Editor: In a clinical trial by Dr Berg and colleagues1 evaluating the benefits of supplementary ultrasound in 3 rounds of annual breast cancer screening and a single magnetic resonance imaging (MRI) scan after completion of the 3 screenings, the Breast Imaging-Reporting and Data System (BI-RADS) was used to categorize and report imaging features of breast lesions. Scores of 3, 4a, 4b, 4c, or 5 were considered test positive. In 7473 screenings with mammography and ultrasound and 612 MRIs, the authors found that adding ultrasound or MRI to mammography increased the detection of cancer but also increased false-positive results. Supplementary ultrasound increased the recall rate from 10.2% with mammography alone to 20.3%, which is higher than the benchmark rate of 10% recommended by the US screening guidelines.2