Synopsis

High-risk women can be identified by genetic testing, mathematical risk prediction models and risk factor assessment. Reasons supporting the use of MRI for breast cancer screening may be summarized in two ways: the performance of MRI and the biologic characteristics of MRI-detected cancer. In general, annual screening is recommended by the ACS for BRCA mutation, any untested first degree relative of a known mutation carrier, anyone with a > 20% lifetime risk of developing breast cancer, history of thoracic radiation, or a known syndrome (Li-Fraumeni or Cowden’s). Abbreviated MRI, ultrafast MRI, or DWI could be additional option for high-risk screening.