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[Comment] Adjunctive ultrasonography in breast cancer screening

The sensitivity and specificity of mammography are limited in highly fibroglandular breasts. Digital mammography provides increased sensitivity in young women and those with moderately dense breasts,1 and digital three-dimensional mammography promises further improvement.2–4 For women with the densest breasts, however, radiography is unlikely to be the optimum solution. MRI, although not affected by breast density, is expensive and access is often limited. Ultrasonography is attractive for breast cancer screening because, likewise, it is not impaired by breast density, and it avoids the use of ionising radiation and the need for breast compression.