{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:13:21Z","timestamp":1773004401221,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001559","name":"Breast Cancer Foundation New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001559","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>While 2D mammography is the standard for breast cancer screening, its sensitivity is reduced in dense breasts, impacting early detection and extent assessment. This study, for the first time in New Zealand, evaluated the utility of supplementary multi\u2010modality imaging (tomosynthesis, ultrasound and magnetic resonance imaging [MRI]) in a risk\u2010stratified population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective case study (May 2022\u2013September 2023, New Zealand private clinic) analysed patients by Tyrer\u2010Cuzick (TC) v8 lifetime risk and by Volpara density categories. All patients in the screening pathway (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092171) underwent 2D mammography and tomosynthesis. Those patients with high breast density received supplementary ultrasound, and those with TC8 Risk scores of \u2265\u200930% were offered abbreviated MRI. Symptomatic patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009230) underwent standard diagnostic workup. Detection rates and extent of disease using multi\u2010modality imaging were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 2401 patients, 205 were high\u2010risk criteria (\u2265\u200930%) and 19 breast cancers (16 invasive, 3 DCIS only) were diagnosed. Tomosynthesis identified 38% (6\/16) more invasive cancers than 2D mammography alone. Ultrasound and MRI detected an additional 27% (4\/16) invasive cancers occult on other modalities, predominantly in those women with high density (Volpara \u2018D\u2019) breasts. Ultrasound and particularly MRI demonstrated superior accuracy in assessing disease extent, including identifying multi\u2010focal and multi\u2010centric disease that was not detected by 2D or tomosynthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Supplementary imaging modalities, particularly MRI, significantly improve breast cancer detection and assessment of disease extent in high\u2010risk women. These findings support a personalised screening approach integrating risk assessment and breast density to guide imaging modality selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70069","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T10:00:02Z","timestamp":1769248802000},"page":"179-187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Breast Cancer Detection in Higher Risk Women: A Multi\u2010Modality Imaging Evaluation in a Private Screening Clinic"],"prefix":"10.1111","volume":"70","author":[{"given":"Sugania","family":"Reddy","sequence":"first","affiliation":[{"name":"Mercy Radiology and Breast Clinic  Auckland New Zealand"},{"name":"Allevia Radiology and Breast Institute  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Pilot Study Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Knowlton","sequence":"additional","affiliation":[{"name":"School of Mathematical and Computational Sciences Massey University  Auckland New Zealand"},{"name":"Department of Obstetrics, Gynaecology &amp; Reproductive Sciences, School of Medicine, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"},{"name":"Te Aka M\u0101tauranga Matepukupuku (Centre for Cancer Research) University of Auckland  Auckland New Zealand"},{"name":"Maurice Wilkins Centre for Molecular Biodiscovery University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Lasham","sequence":"additional","affiliation":[{"name":"Te Aka M\u0101tauranga Matepukupuku (Centre for Cancer Research) University of Auckland  Auckland New Zealand"},{"name":"Maurice Wilkins Centre for Molecular Biodiscovery University of Auckland  Auckland New Zealand"},{"name":"Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062790"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03502-3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2301020589"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.60.8869"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-0034"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120674"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.18.2151"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.00.4960"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jbi\/wbz006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1214\/19-STS729"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/03036758.2025.2463448"},{"key":"e_1_2_11_13_1","unstructured":"Breast Cancer Aotearoa Coalition \u201cBreast Density Matters \u201d(2022) https:\/\/www.breastcancer.org.nz\/content\/breast\u2010density\u2010matters."},{"key":"e_1_2_11_14_1","first-page":"342","volume-title":"Robust Breast Composition Measurement\u2014Volpara","author":"Highnam R.","year":"2010"},{"key":"e_1_2_11_15_1","unstructured":"A.Agostinelli \u201cAbbreviated Breast MRI: How Have We Achieved It? \u201d in Proceedings of the International Society for Magnetic Resonance in Medicine (ISRM 2020)."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020200006"},{"key":"e_1_2_11_17_1","unstructured":"\u201cIBISBreast Cancer Risk Evaluation Tool \u201d(2017) https:\/\/ems\u2010trials.org\/riskevaluator\/."},{"key":"e_1_2_11_18_1","volume-title":"National Institute for Health and Care Excellence: Guidelines","author":"National Institute for Health and Care Excellence (NICE)","year":"2023"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-10951-w"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-024-01653-4"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00582-3"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.13754"}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1754-9485.70069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:36:16Z","timestamp":1772994976000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.70069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/1754-9485.70069"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.70069","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"2025-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}