This Radiology report describes the design of DENSE-2, a multicentre randomised trial embedded in the Dutch screening programme. It enrols women with extremely dense breasts and a negative screening mammogram, and compares supplemental screening with contrast-enhanced mammography or abbreviated MRI against mammography alone, over two consecutive rounds with the same technique each time.
The background is the earlier DENSE trial, which showed that supplemental full-protocol MRI reduced interval cancers in this group, but cost and capacity limit its use in population programmes. The primary aim in DENSE-2 is to determine whether the two cheaper techniques reduce interval cancers compared with mammography. Performance, feasibility and acceptability will also be reported.
The abstract describes the design and gives no outcome data, so there is nothing yet to change practice. It is worth knowing about because it will inform which supplemental test is used for women with dense breasts, a question many programmes, including those with limited MRI capacity, face.
- DENSE-2 compares contrast-enhanced mammography and abbreviated MRI against mammography alone.
- The primary aim is the interval cancer rate in women with extremely dense breasts and a negative mammogram.
- No outcome data are reported yet; do not extrapolate.
- The earlier DENSE trial supports full-protocol MRI in this group, but capacity is limited.
- Follow your national programme's guidance on dense breasts.
Why it matters
It targets the capacity and cost barriers that stop many programmes offering supplemental imaging.
Don't overread it
This is a trial design report with no results, so it does not show either test works.
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