New Research Confirms Better Screening Options of Dense Breasts

A major new study out of the UK is challenging the way we screen women with dense breasts. The randomized, controlled trial looked at more than 9,000 women between the ages of 50 and 70 who had dense breast tissue and a recent negative mammogram. Researchers compared three supplemental imaging options —MRI, contrast-enhanced mammography, and ultrasound—to see which method was best at catching what the standard mammogram might miss.

The results were clear. MRI scans detected 17.4 cancers per 1,000 exams. Contrast-enhanced mammograms detected even more — 19.2 cancers per 1,000 exams. Ultrasounds, by comparison, found just 4.2. According to the study, published in The Lancet Oncology, both MRI and contrast - enhanced mammography significantly outperformed ultrasound in identifying cancers hidden in dense tissue.

That’s important because dense breast tissue is common and can mask cancer on standard mammograms. Nearly half of women over 40 in the U.S. have dense breasts, according to the FDA. Dense tissue not only makes imaging harder to read, it also increases the risk of developing breast cancer in the first place.

One catch for American women: while contrast-enhanced mammography is approved by the FDA for diagnostic purposes—such as investigating a suspicious lump—it is not currently approved for routine breast cancer screening. That regulatory gap limits access, even though the UK study shows it could be a valuable tool for early detection in women with dense tissue.

MRI remains the gold standard for supplemental screening, but it’s expensive, less available, and may not be right for everyone. Contrast-enhanced mammography, by contrast, is quicker and more affordable. And as this study shows, it may be just as effective — if not slightly better—at finding cancers that mammograms miss.

Dense breast tissue can make cancer harder to find and easier to miss. This study makes it clear that not all screening methods are equal.