Table 2.
Multidisciplinary recommendations for annual supplemental magnetic resonance imaging screening in higher-than-average-risk women
| Organization | BRCA Carriers/First-Degree Relativesa | Family History | Prior Radiation | Personal History | Dense Tissue | History of Atypiab |
|---|---|---|---|---|---|---|
| ACS 2007 | BRCA1/2/select mutations | If LTR ≥20% | Age 10–30 y | NR | NR | NR |
| ACR 2018 | BRCA1/2/select mutations | If LTR ≥20% | Age<30 y | If early diagnosis (before age 50) | If personal history (prior breast cancer) | If other risk factors |
| ASBrS 2019 | BRCA1/2/select mutations | If strong family history | Age 10–30 y | If early diagnosis (before age 50 y) | If personal history (prior breast cancer) | NR |
| NCCN 2020 | BRCA1/2/select mutations | If family history suggests hereditary pattern despite absence of mutation (eg, early diagnosis before age 30 y) | Age<30 y | NR | NR | If LTR ≥20% |
| EUSOBI 2015 | BRCA1/2/select mutations | Selective | Age<30 y | NR | NR | NR |
| ECIBS 2020c | NS | NR | NS | NS | NR | NR |
| ACOG 2017 | BRCA1/2/select mutations | If LTR ≥20% | Age 10–30 y | If other risks | NR | NR |
Abbreviations: ACR, American College of Radiology; ASBrS, American Society of Breast Surgeons; ECIBS, European Commission Initiative on Breast Cancer; EUSOBI, European Society of Breast Imaging; NCCN, National Comprehensive Cancer Network; NR, screening not recommended or insufficient evidence to recommend for or against; NS, not specified.
MR imaging is consistently recommended for BRCA mutation carriers and untested first-degree relatives, but more variably recommended or considered for other mutations.
Atypia refers to atypical epithelial hyperplasia, including atypical lobular hyperplasia, lobular carcinoma in situ, and atypical ductal hyperplasia.
The ECIBS guidelines primarily address average-risk women that attend organized screening programs in Europe but also include select higher-than-average-risk groups such as those with family history or high breast tissue density.