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More than half of women younger than 50 and one third of women older than 50 have dense breast tissue, which can hamper mammographic detection of noncalcified breast cancers. In a prospective multicenter trial, investigators randomized 2637 women (mean age, 55) at high risk for breast cancer to screening by mammography alone or mammography plus ultrasound. More than half (53%) of the women had histories of previous breast cancer, and 19% had a lifetime risk for breast cancer of ≥25%, based on the Gail model.
Breast cancer was diagnosed in 40 participants (1.5%) during 12 months of follow-up. Half of the cancers were detected with mammography alone (yield of 7.6 per 1000), resulting in a sensitivity of 50% and a positive predictive value (PPV…