Sensible Medicine Alternative Modalities for Breast Cancer Screening
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Feb 18, 2026 Dr. Jennifer Rusiecki, Associate Professor of Medicine at the University of Chicago and director of women’s health in residency, talks about breast density and screening. She explains why density causes confusing warning letters. She reviews supplemental options like 3D mammography, whole-breast ultrasound, MRI and contrast-enhanced mammography. She also addresses stratified screening, prevention, and counseling approaches.
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Breast Density Is A Moderate Risk Factor
- Breast density is an independent, moderate-level risk factor for breast cancer and not a diagnosis itself.
- For many, heterogeneously dense breasts confer risk similar to one glass of wine nightly, per Jennifer Rusiecki.
Tomosynthesis Improves Detection But Has Limits
- Tomosynthesis (3D mammography) modestly improves cancer detection and lowers recall rates versus standard digital mammography.
- Its benefit weakens in extremely dense breasts, which remain a distinct challenge.
Patients Often Unaware They Had Tomosynthesis
- Many patients don't realize they already receive tomosynthesis because centers often run both scans together.
- Vinay Prasad and Jennifer Rusiecki noted patients report surprise when reports list 'breast tomo'.