MRI Breast Without and With IV Contrast Although data are limited regarding the use of breast MRI without and with IV contrast for screening women at average risk, one study has demonstrated that breast MRI demonstrates incremental cancer detection (15-16 cancers per 1,000 breast MRI examinations) over screening mammography with or without screening ultrasound (US) in average-risk women irrespective of breast density [42]. Breast MRI also decreases interval cancers [42,43]. In the DENSE trial, breast MRI significantly reduced interval cancers within women with extremely dense breast tissue and normal mammography, so the European Society of Breast Imaging now recommends screening breast MRI every 2 to 4 years in women 50 to 70 years of age with extremely dense breasts [43,44]. Compared to average breast density (near the threshold between heterogeneously dense and scattered areas of fibroglandular density), the relative risks for developing breast cancer are 1.2 for heterogeneously dense and 2.1 for extremely dense breasts [28]. Some health care providers may therefore consider women with extremely dense breasts to no longer be average risk. MRI Breast Without and With IV Contrast Abbreviated Data are limited regarding the use of abbreviated breast MRI without and with IV contrast for screening women at average risk. The ECOG-ACRIN abbreviated MRI trial demonstrated a significantly higher CDR for abbreviated breast MRI without and with IV contrast (15 cancers per 1,000) compared with DBT (6 cancers per 1,000), although the study recruited women with dense breasts [45]. In addition to dense breasts, women enrolled in the trial had variable 5 and 10 year risk profiles based upon the Breast Cancer Surveillance Consortium risk calculator and 19% reported 1 or more first degree relatives with breast cancer [45].
Female Breast Cancer Screening. MRI Breast Without and With IV Contrast Although data are limited regarding the use of breast MRI without and with IV contrast for screening women at average risk, one study has demonstrated that breast MRI demonstrates incremental cancer detection (15-16 cancers per 1,000 breast MRI examinations) over screening mammography with or without screening ultrasound (US) in average-risk women irrespective of breast density [42]. Breast MRI also decreases interval cancers [42,43]. In the DENSE trial, breast MRI significantly reduced interval cancers within women with extremely dense breast tissue and normal mammography, so the European Society of Breast Imaging now recommends screening breast MRI every 2 to 4 years in women 50 to 70 years of age with extremely dense breasts [43,44]. Compared to average breast density (near the threshold between heterogeneously dense and scattered areas of fibroglandular density), the relative risks for developing breast cancer are 1.2 for heterogeneously dense and 2.1 for extremely dense breasts [28]. Some health care providers may therefore consider women with extremely dense breasts to no longer be average risk. MRI Breast Without and With IV Contrast Abbreviated Data are limited regarding the use of abbreviated breast MRI without and with IV contrast for screening women at average risk. The ECOG-ACRIN abbreviated MRI trial demonstrated a significantly higher CDR for abbreviated breast MRI without and with IV contrast (15 cancers per 1,000) compared with DBT (6 cancers per 1,000), although the study recruited women with dense breasts [45]. In addition to dense breasts, women enrolled in the trial had variable 5 and 10 year risk profiles based upon the Breast Cancer Surveillance Consortium risk calculator and 19% reported 1 or more first degree relatives with breast cancer [45].