Comstock CE, Gatsonis C, Newstead GM, et al. - This study intended to compare the screening performance of abbreviated breast magnetic resonance imaging (MRI) and digital breast tomosynthesis (DBT) in women with dense breasts. Between December 2016 and November 2017, a cross-sectional study with longitudinal follow-up at 48 academic, community hospital, and private practice sites in the United States and Germany, carried out among average-risk women aged 40 to 75 years with heterogeneously dense or extremely dense breasts undergoing routine screening. The invasive cancer detection rate was the primary outcome. Secondary endpoints were sensitivity, specificity, additional imaging recommendation rate, and positive predictive value (PPV) of biopsy, using invasive cancer and ductal carcinoma in situ (DCIS) to define a positive reference standard. Compared with DBT, abbreviated breast MRI among women with dense breasts undergoing screening was correlated with a significantly higher rate of invasive breast cancer detection. Future studies are required to better understand the association between screening methods and clinical outcome.