Overcoming Barriers for Breast Cancer Detection in Women with High Breast Density [Letter]

The article titled "Awareness of Breast Cancer Risk Factors in Women with vs Without High Breast Density" by Endrikat et al 1 provides profound insights into the differences in cancer risk factor perception between women with high breast density (HBD) and those with non-high breast density.From a radiomedical perspective, this study not only highlights breast density as a core factor in assessing breast cancer risk but also lays a solid foundation for exploring new pathways and strategies for cancer screening and detection.What are the barriers to the widespread adoption of MRI screening for women with HBD? Cost, availability, and patient compliance are potential factors.MRI machines are expensive, and the procedure itself can be timeconsuming and uncomfortable for some patients.Moreover, not all healthcare providers have access to MRI machines, particularly in low-and middle-income countries. 2To improve accessibility and affordability, policymakers and healthcare providers need to collaborate to develop cost-effective solutions and increase the availability of MRI machines in various settings.In addition to MRI, other imaging technologies, such as ultrasound and tomosynthesis, have shown promise in improving cancer detection in dense breasts.Ultrasound, in particular, is a cost-effective and widely used modality that can serve as an adjunct to mammography.However, it faces limitations in post-neoadjuvant therapy (NT) assessments due to breast density, lesion changes, and fibrosis.In contrast, Digital Breast Tomosynthesis (DBT) offers a promising alternative by addressing these challenges, particularly in scenarios where MRI is contraindicated or inaccessible, thereby enhancing the comprehensive evaluation of breast cancer response to therapy. 3