ACS recommendations for breast MRI screening as an adjunct to mammography

Recommend annual MRI screening (based on high risk of breast cancer and high sensitivity of MRI*)

BRCA mutation

First-degree relative of BRCA carrier, but untested

Lifetime risk >20 to 25% or greater, as defined by BRCAPRO or other models that are largely dependent on family history

Recommend annual MRI screening (based on high risk of breast cancer)

Radiation to chest between age 10 and 30 years

Li-Fraumeni syndrome and first-degree relatives

Cowden and Bannayan-Riley-Ruvalcaba syndromes and first-degree relatives

Insufficient evidence to recommend for or against MRI screening^Δ

Lifetime risk 15 to 20%, as defined by BRCAPRO or other models that are largely dependent on family history

Lobular carcinoma in situ or atypical lobular hyperplasia

Atypical ductal hyperplasia

Heterogeneously or extremely dense breast on mammography

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

Recommend against MRI screening (based on expert consensus opinion)

Women at <15% lifetime risk

ACS: American Cancer Society; MRI: magnetic resonance imaging.
* Evidence from nonrandomized screening trials and observational studies.
Δ Payment should not be a barrier. Screening decisions should be made on a case-by-case basis, as there may be particular factors to support MRI.

Reproduced with permission from: Saslow D, Boetes C, Burke W, et al. American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography. CA Cancer J Clin 2007; 57:75. Copyright © 2007 John Wiley & Sons, Inc.

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ACS recommendations for breast MRI screening as an adjunct to mammography