What are the ACS criteria for MRI in breast cancer screening?

Updated: Apr 10, 2019
  • Author: Erin V Newton, MD; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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Answer

Answer

The American Cancer Society (ACS) has established criteria for using breast MRI screening. [19] Based on evidence from nonrandomized trials and observational studies, the ACS recommends annual breast MRI screening in addition to mammography in patients with the following risk factors:

  • BRCA mutation

  • First-degree relative of BRCA carrier but untested

  • Lifetime risk approximately 20-25% or greater, as defined by BRCAPRO or other risk models

The ACS found insufficient evidence to recommend for or against MRI screening in patients with the following risk factors:

  • Lifetime risk 15-20%, as defined by BRCAPRO or other risk models

  • Lobular carcinoma in situ (LCIS), atypical lobular hyperplasia (ALH), or atypical ductal hyperplasia (ADH)

  • Heterogeneously or extremely dense breast on mammography

  • Personal history of breast cancer, including ductal carcinoma in situ

The ACS does not recommend the use of breast MRI in women who have a less than 15% lifetime risk of breast cancer. For those with average risk, a combination of clinical breast examinations and yearly mammograms is recommended. For women who have a 15-20% lifetime risk of developing breast cancer, the ACS found insufficient evidence to recommend screening MRI.


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