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Women with extremely dense breast tissue have excess risk for developing breast cancer; however, no specific guidelines address the evaluation of such women. In a Dutch trial, 40,000 women (age range, 50–75) with extremely dense breasts and a recent negative screening mammogram were randomized to undergo — or not undergo — supplemental breast MRI.
Among women assigned to breast MRI, 59% actually underwent MRI imaging; among those women, 95 per 1000 were recalled for further evaluation, and breast cancer was detected in 16 per 1000. MRI-detected cancers were more likely to be small and categorized as ductal carcinoma in situ. The rate of interval cancers within 2 years (the interval before the next routine biennial mammogram) was significantl…