Breast cancer screening in average and high-risk women

Breast cancer is the most common cancer among females world-wide with rising incidence. In the United States, screening mammography and advances in therapy have lowered mortality by 41% since 1990. Screening mammography is supported by randomized control trials (RCT), observational studies, and com-puter model data. Digital breast tomosynthesis is a new technol-ogy that addresses limitations in mammography resulting from overlapping breast tissue, improving its sensitivity and specificity. Patients at high risk for breast cancer include those with a >= 20% lifetime risk, high-risk germline mutation, or history of thoracic radiation treatment between 10-30 years of age. Such patients are recommended to undergo annual screening mammography and adjunctive annual screening breast MRI. Patients unable to un-dergo MRI may undergo whole breast ultrasound or contrast -enhanced mammography. Pregnant and lactating patients at average risk for breast cancer are recommended to undergo age -appropriate screening mammography.(c) 2021 Elsevier Ltd. All rights reserved.