Don’t routinely use breast MRI for breast cancer screening in average risk women.

Rationale and Comments

MRI screening should be reserved for those at increased risk. Women considered at high risk include: known BRCA gene mutation carriers; first-degree relatives of known BRCA gene mutation carriers; those with a lifetime risk exceeding 20% as measured by risk-assessment tools based primarily on family history of breast cancer; and those with a clinical history associated with a significant risk for breast cancer, including women who received mantle radiation before the age of 30.

Sponsoring Organizations

• Society of Surgical Oncology

Sources

• American Cancer Society guidelines

Disciplines

• Gynecologic
• Oncologic
• Preventive Medicine

References

• Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89. Erratum in: CA Cancer J Clin. 2007 May-Jun;57(3):185.
  
• Mulder RL, Kremer LC, Hudson MM, Bhatia S, Landier W, Levitt G, Constine LS, Wallace WH, van Leeuwen FE, Ronckers CM, Henderson TO, Dwyer M, Skinner R, Oeffinger KC; International Late Effects of Childhood Cancer Guideline Harmonization Group. Recommendations for breast cancer surveillance for female survivors of childhood, adolescent, and young adult cancer given chest radiation: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Lancet Oncol. 2013 Dec;14(13):e621-9.