How do you counsel women with a history of breast cancer who have dense breasts, with regards to mammography screening?

The question of how best to follow women after treatment for breast cancer is one that is of great concern to oncologists. Many factors play into the type and frequency of screening. However, little definitive data exists showing benefit of anything above annual screening with mammography. For our survivors with fatty replaced or scattered density breasts (density BIRADS 1 or 2) we recommend annual screening mammography along with clinical follow up with their cancer and primary care providers.

Patients with extremely dense breasts have more favorable cancers (ER/PR positive, HER2 negative, more lobular cancers, and more mammographically occult cancers than their counterparts with less-dense breasts (1)

Survival, free of local recurrence and distant metastases in 403 patients followed for five years or more was not related to mammographic visibility (2)

Can you detect local recurrence with mammography in someone whose initial cancer was occult? Long before MRI or even ultrasound screenin...