Kerlikowske K, Sprague BL, Tosteson ANA, et al. - Researchers sought to identify women at high risk of advanced breast cancer among those with dense breasts who are undergoing routine screening. In this prospective cohort study, 638,856 women (aged 40 to 74 years), who had 1,693,163 screening digital mammograms taken at Breast Cancer Surveillance Consortium (BCSC) imaging facilities, were assessed. Findings revealed the occurrence of high rates of advanced breast cancer in women with heterogeneously dense breasts and a 5-year risk of 2.5% or higher and those with extremely dense breasts and a 5-year risk of 1.0% or higher. Subgroups at highest risk of advanced cancer were thus identified by evaluating the 5-year risk in women with dense breasts and this was identified to be a more efficient strategy for supplemental imaging discussions than targeting all women with dense breasts.