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Screening mammography lowers breast cancer mortality by 15% to 20%. Ultrasound detects breast cancer that is missed by mammography (particularly in dense breast tissue, which is a risk factor itself) in single-center trials, but its accuracy could be operator dependent. In a prospective multisite trial, researchers compared the accuracy of mammography plus ultrasound to that of mammography alone in 2637 women (age range, 25–91; mean age, 55) who had dense breast tissue in at least one quadrant and who were at high risk for breast cancer (53% had personal histories of breast cancer; 19% had ≥25% lifetime risk as determined by a predictive model).
Women received both mammography and ultrasound in random order; tests were read separately. If ei…