The extent and determinants of supplemental screening among women with dense breasts are unclear. We evaluated a retrospective cohort of 498,855 women aged 40-74 years with heterogeneously or extremely dense breasts who obtained 1,176,251 negative screening mammography examinations during 2011-2019 in the United States. Overall, 2.8% and 0.3% of mammograms had supplemental ultrasound or MRI within one year, respectively. Onsite availability was associated with ultrasound (odds ratio [OR]=4.35; 95%CI : 4.21-4.49) but not MRI (OR = 0.94; 95%CI : 0.85-1.04). Facility academic affiliation and for-profit status were inversely associated with supplemental ultrasound (OR = 0.53; 95%CI : 0.49-0.57 and OR = 0.83; 95%CI : 0.81-0.86, respectively) and positively associated with supplemental MRI (OR = 3.04; 95%CI : 2.86-3.46 and OR = 1.88; 95%CI : 1.66-2.12, respectively). Supplemental screening was more likely to occur after passage of state-specific density notification laws than before passage (OR = 3.56; 95%CI 3.30-3.84 and OR = 1.79; 95%CI 1.60-2.00, respectively). These results show that supplemental breast imaging utilization has been uncommon and was related to facility factors and density legislation.

中文翻译：

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美国乳腺致密女性乳腺 X 线摄影阴性后乳腺癌补充筛查


对乳房致密女性进行补充筛查的范围和决定因素尚不清楚。我们评估了 498,855 名年龄在 40-74 岁之间患有异质性或极致密乳房的女性的回顾性队列，这些女性在 2011-2019 年期间在美国获得了 1,176,251 次阴性筛查乳腺 X 光检查。总体而言，分别有 2.8% 和 0.3% 的乳腺 X 线照片在一年内进行了补充超声或 MRI。现场可用性与超声相关 （比值比 [OR]=4.35;95%CI ： 4.21-4.49），但与 MRI 无关 （OR = 0.94;95%CI ： 0.85-1.04）。机构学术隶属关系和营利性地位与补充超声呈负相关 （OR = 0.53;95%CI ： 0.49-0.57 和 OR = 0.83;95%CI ： 0.81-0.86），与补充 MRI 呈正相关 （OR = 3.04;95%CI： 2.86-3.46 和 OR = 1.88;95%CI ： 1.66-2.12）。补充筛查在各州特定密度通知法通过后比通过前更有可能发生（分别为 OR = 3.56;95% CI 3.30-3.84 和 OR = 1.79;95%CI 1.60-2.00）。这些结果表明，补充乳腺成像的使用并不常见，并且与设施因素和密度立法有关。