title: High mammographic breast density and its implications for the early detection of breast cancer.
abstract: OBJECTIVE
  Women with high mammographic breast density are at increased risk of breast cancer. This study explores whether these women should receive intensified screening (more frequent screening or screening with alternative techniques that increase the length of the preclinical detectable phase) to reduce further breast cancer mortality.
  
  
  METHODS
  Mathematical models were used to estimate the effects of intensified screening in women with high breast density. The effects were expressed as a reduction in the number of interval cancers.
  
  
  RESULTS
  If women with > 25% breast density (comprising about one fifth of all women) are screened annually instead of biennially, an 18% reduction in the total number of interval cancers can be expected. Screening these women with alternative screening techniques biennially may produce the same reduction, provided that these techniques double the mean lead time.
  
  
  CONCLUSIONS
  By screening women with dense breasts more intensively, many more breast cancers can theoretically be detected at an early stage. The results provide an early indication of what may be expected from screening strategies. Next, cost-benefit analyses are needed.
authors.affiliation: Department of Epidemiology, University of Nijmegen, The Netherlands.
authors.forename: C H
authors.initials: CH
authors.lastname: van Gils
authors.forename: J D
authors.initials: JD
authors.lastname: Otten
authors.forename: J H
authors.initials: JH
authors.lastname: Hendriks
authors.forename: R
authors.initials: R
authors.lastname: Holland
authors.forename: H
authors.initials: H
authors.lastname: Straatman
authors.forename: A L
authors.initials: AL
authors.lastname: Verbeek
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography; D008403:Mass Screening / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors