A T2-weighted sequence may also be included. There are currently limited data on screening women with dense breasts at intermediate lifetime risk with AB-MRI. In 2 retrospective reader studies, in women recently diagnosed with unifocal breast cancer, the sensitivity of AB-MRI was comparable with the full protocol [36,37]. When the performance of AB-MRI was compared with screening US and mammography, 12 cancers in 12 women (CDR 15/1,000) were detected, 7 of which were not detected on WBUS and mammography [38]. In a prospective observational study of 443 women with mild to moderately elevated lifetime risk for breast cancer, AB- MRI had a similar diagnostic accuracy as the full MRI protocol [39]. MRI Breast Without IV Contrast There is no relevant literature regarding the use of MRI breast without IV contrast for supplemental screening in intermediate-risk women with dense breasts. MRI Breast Without and With IV Contrast There is some relevant literature supporting the use of MRI breast without and with IV contrast for supplemental screening in intermediate-risk women, specifically in women with a history of lobular carcinoma in situ or a personal history of breast cancer, although these studies included all breast densities [40-42]. At the time of this writing, the American Cancer Society was re-reviewing the literature regarding intermediate-risk women; however, its current stance, last updated in 2007, states there is insufficient evidence to formulate a recommendation in this group [15]. As of 2018, the ACR recommends annual surveillance MRI in women with dense breasts and with a personal history of breast cancer, as well as in women who were diagnosed before age 50 [43].
Supplemental Breast Cancer Screening Based on Breast Density. A T2-weighted sequence may also be included. There are currently limited data on screening women with dense breasts at intermediate lifetime risk with AB-MRI. In 2 retrospective reader studies, in women recently diagnosed with unifocal breast cancer, the sensitivity of AB-MRI was comparable with the full protocol [36,37]. When the performance of AB-MRI was compared with screening US and mammography, 12 cancers in 12 women (CDR 15/1,000) were detected, 7 of which were not detected on WBUS and mammography [38]. In a prospective observational study of 443 women with mild to moderately elevated lifetime risk for breast cancer, AB- MRI had a similar diagnostic accuracy as the full MRI protocol [39]. MRI Breast Without IV Contrast There is no relevant literature regarding the use of MRI breast without IV contrast for supplemental screening in intermediate-risk women with dense breasts. MRI Breast Without and With IV Contrast There is some relevant literature supporting the use of MRI breast without and with IV contrast for supplemental screening in intermediate-risk women, specifically in women with a history of lobular carcinoma in situ or a personal history of breast cancer, although these studies included all breast densities [40-42]. At the time of this writing, the American Cancer Society was re-reviewing the literature regarding intermediate-risk women; however, its current stance, last updated in 2007, states there is insufficient evidence to formulate a recommendation in this group [15]. As of 2018, the ACR recommends annual surveillance MRI in women with dense breasts and with a personal history of breast cancer, as well as in women who were diagnosed before age 50 [43].