Guidelines on MRI Detection of Breast Cancer

The American Cancer Society yesterday released new guidelines for breast cancer screening with MRI as an adjunct to mammography. The principal recommendations, based on literature published between 2002 and 2006, follow.


Annual MRI screening for:


-- those with BRCA mutations
-- first-degree relatives of BRCA carriers

-- those with 20% or greater lifetime risk, as defined by BRCAPRO and other family-history-dependent models

-- those having received chest irradiation between age 10 and 30

-- those with Li-Fraumeni syndrome, Cowden syndrome, and Bannayan-Riley-Ruvalcaba syndrome or their first-degree relatives



Insufficient evidence to recommend for or against MRI screening for:



-- those with a lifetime risk of 15-20%

-- those with lobular carcinoma in situ or atypical lobular hyperplasia

-- those with atypical ductal hyperplasia

-- those with heterogeneous or extreme breast density on mammography

-- those with a personal history of breast cancer, including ductal carcinoma in situ



Women with a less than 15% lifetime risk are recommended not to have MRI screening.