title: Tailored supplemental screening for breast cancer: what now and what next?
abstract: OBJECTIVE
  This article reviews breast cancer risk assessment and the rationale for current screening guidelines, including when to consider using supplemental screening with MRI or sonography in addition to mammography, and discusses other emerging technologies. Radiologists can help identify women who may benefit from supplemental screening and can help to recommend when and which techniques to perform for this additional screening.
  
  
  CONCLUSIONS
  Mammography remains the mainstay of breast cancer screening. Mammography should be performed as digital imaging when possible in women with dense breasts. In women at high risk, particularly if they also have dense breasts, annual MRI is recommended, although further validation of outcomes is needed. In intermediate-risk women with dense breasts, especially those with other risk factors, and in high-risk women with dense breasts who are unable to tolerate MRI, supplemental sonography screening is an option at facilities with availability of qualified personnel. Developing technologies are not appropriate for screening at this time, although further study is encouraged.
authors.affiliation: Department of Radiology, American Radiology Services, Johns Hopkins Green Spring, Lutherville, MD 21093, USA. wendieberg@gmail.com
authors.forename: Wendie A
authors.initials: WA
authors.lastname: Berg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D055088:Early Detection of Cancer; D005260:Female; D015902:Gamma Cameras / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data