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[Correspondence] Adjunctive ultrasonography for breast cancer screening

In the J-START randomised controlled trial,1 adjunctive ultrasonography increased the sensitivity of screening from 77·0% with mammography alone to 91·1% at the expense of a substantial reduction in specificity in women with an average risk of breast cancer. Ohuchi and colleagues1 state that adjunctive ultrasonography could offer a low-cost way to increase sensitivity and detection rates of early breast cancer in women with dense breasts. However, considering that adjunctive ultrasonography increased recall rates from 8·8% with mammography alone to 12·6%, and biopsy rates from 1·8% to 4·5%,1 I would not advocate routine screening with adjunctive ultrasonography.