To address the persistent evidence gaps in breast cancer screening, research priorities should focus on several key areas. Firstly, studies should investigate the comparative effectiveness of digital breast tomosynthesis versus standard mammography for primary screening to determine the optimal imaging modality. Additionally, research is needed to evaluate the benefits and harms of continuing screening for women aged 75 years and older, as well as the effectiveness of supplemental screening modalities such as breast ultrasonography, digital breast tomosynthesis, or MRI in women with dense breasts. Furthermore, studies should aim to determine the proportion of ductal carcinoma in situ lesions detected by screening that would not have caused harm, helping to reduce overdiagnosis and overtreatment. Research on the best strategies for breast cancer screening in women with dense breasts, including the potential benefits of additional screening, is crucial to inform evidence-based guidelines and practices. Collaborative efforts between researchers, healthcare providers, and policymakers are essential to address these research priorities and improve breast cancer screening outcomes.