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Evidence to Improve Care

Supplemental Screening as an Adjunct to Mammography for Breast Cancer Screening in People With Dense Breasts

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding supplemental screening as an adjunct to mammography for people with extremely dense breasts. 

Read the final recommendation report


Screening for breast cancer is the process of looking for the disease before any symptoms appear, so that it can be caught and treated early. Many factors affect a person’s risk for breast cancer, including age, a strong family history of the disease, and breast density. Variations in breast density are normal and common, but higher breast density increases the risk of cancer and makes it harder to see cancers on a mammogram (a 2-dimensional breast x-ray).

One way to improve cancer detection for people with dense breasts might be to use other types of imaging in addition to mammography (called supplemental screening). Types of breast imaging that could be added include contrast-enhanced mammography, ultrasound, digital breast tomosynthesis (3-dimensional breast x-ray), or magnetic resonance imaging (MRI).

This health technology assessment looked at how accurate, safe, effective, and cost-effective supplemental screening is for people with dense breasts. It also looked at the budget impact of publicly funding supplemental screening; the experiences, preferences, understandings, and values of people with dense breasts and their health care providers; and ethical issues related to supplemental screening for people with dense breasts.

Read the full health technology assessment report for more information.

Supplemental Screening as an Adjunct to Mammography for Breast Cancer Screening in People With Dense Breasts: A Health Technology Assessment
December 2023

  • PDF

  • XML (accessible version to come)

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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