Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancerenglish
Version: 3 ID: 15-11 Jan 2018
Type of Content: Guidelines & Advice, Clinical
Document Status: In-Review
Women at very high risk for breast cancer, ‘very high risk’ being defined as:
- Known mutation in BRCA1, BRCA2 or other gene predisposing to a markedly elevated breast cancer risk.
- Untested first-degree relative of a carrier of such a gene mutation.
- Family history consistent with a hereditary breast cancer syndrome and estimated personal lifetime cancer risk >25%.
- High-risk marker on prior biopsy (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ [LCIS]).
- Radiation therapy to chest (before age 30 and at least eight years previous).
- What is the effectiveness of adding breast magnetic resonance imaging (MRI) to standard screening (mammography) compared to screening mammography alone?
- Does the addition of breast MRI to standard screening detect breast cancer at an earlier stage?
- What is the optimal frequency of MRI screening?
- Are there subgroups (risk category, age, or breast density) that benefit more from MRI screening than do others?
- What harms are associated with MRI screening, and are there any relative or absolute contraindications to its use?
- In the presence of an abnormal finding seen only on MRI imaging, what is the optimal workup and follow-up after screening?
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