Table 3.

Recommendations for annual breast MRI screening (16)

Risk Group	Recommendation	Level of Evidence
BRCA mutation carrier	Recommend annual MRI screening as an adjunct to mammography	Based on non-randomized screening trials and observational studies
First-degree relative of BRCA mutation carrier
Lifetime risk of breast cancer ≥20% as defined by family-history based model
History of radiation to chest wall between age 10 – 30 years	Recommend annual MRI screening as an adjunct to mammography	Based on expert consensus opinion
Li-Fraumeni syndrome and first-degree relatives
Cowden and Bannayan-Riley-Ruvulcaba syndromes and first-degree relatives
Lifetime risk of breast cancer 15-20% as defined by family-history based model	Insufficient evidence to recommend for or against annual MRI as adjunct to mammography; decision should be made on individual basis	Insufficient evidence to make recommendation
Pre-maligant breast lesion (lobular carcinoma in situ, atypical lobular hyperplasia, atypical ductal hyperplasia)
Dense breasts on mammography
Personal history of invasive breast cancer or ductal carcinoma in situ
Women at <15% lifetime risk	Recommend against annual MRI screening	Based on expert consensus opinion