II. Indications
-
Breast Cancer Screening in high risk women
- BRCA1 or BRCA2 genetic mutation
- First degree relative with BRCA1 or BRCA2
- Radiation exposure to chest under age 30 years
- Lifetime Breast Cancer risk estimated >20%
- Other Genetic Syndromes (and an affected 1d relative)
- Li-Fraumeni Syndrome
- Cowden syndrome
- Bannayan-Riley-Ruvalcaba Syndrome
- References
-
Breast Cancer evaluation
- Define extent of Breast Cancer index lesion
- Identify concurrent cancer in contralateral Breast
- Assess response to Chemotherapy
- Define new Breast Cancers in those with implants
- Assess for suspected residual cancer post-surgery
- Inconclusive Mammogram, breast Ultrasound, CBE
- References
III. Protocol: Breast Cancer Screening
- Annual Breast MRI starting at age 30 in high risk women (for indications as above)
- Continue Mammograms and Clinical Breast Exams
IV. Efficacy: Breast Cancer Screening
- Test Sensitivity: 79% (Mammogram: as low as 33%)
-
Test Specificity: 90% (Mammogram: 95%)
- Higher risk of False Positives than Mammogram
- References
V. Disadvantages: Breast Cancer Screening
- Too expensive for general population screening
- Twice the False Positive Rate (10%) compared with Mammogram (5%)
- Would substantially increase unnecessary testing if MRI applied to general population screening
VI. Resources
- Breast Cancer Risk Assessment Tool