In one observational study in women <50 years of age, restricting screening to women with a first-degree family history, extremely dense breast tissue, or both, would cause 66% of potentially screen-detected cancers to be missed [41]. To maximize the benefits, the ACR recommends annual screening mammography beginning no later than 40 years of age for women at intermediate risk [3]. Women should continue screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified [5,8]. For those with a family history of breast cancer, mammography should begin earlier if familial breast cancer occurred at a young age, typically 10 years prior to the youngest age at presentation but generally not before 30 years of age [6]. For women who have lobular neoplasia or atypical hyperplasia diagnosed prior to 40 years of age, annual screening mammography should be performed from time of diagnosis but generally not prior to 30 years of age [38]. Early detection of second breast cancers improves survival, so patients with a personal history of breast cancer should undergo annual mammography or DBT for surveillance following breast conservation therapy [3]. Mammography With IV Contrast Data are limited regarding the use of mammography with IV contrast for breast cancer screening in intermediate- risk women. To date, published studies have predominantly included women with dense breasts and other risk factors resulting in intermediate- or high-risk profiles. Compared to mammography alone, mammography with IV contrast increases cancer detection (incremental CDR = 6.6-13 per 1,000) in women at elevated risk [57-60]. Female Breast Cancer Screening MRI Breast Without and With IV Contrast MRI has a higher CDR than mammography alone, DBT, or mammography/DBT combined with US [61-64].
Female Breast Cancer Screening. In one observational study in women <50 years of age, restricting screening to women with a first-degree family history, extremely dense breast tissue, or both, would cause 66% of potentially screen-detected cancers to be missed [41]. To maximize the benefits, the ACR recommends annual screening mammography beginning no later than 40 years of age for women at intermediate risk [3]. Women should continue screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified [5,8]. For those with a family history of breast cancer, mammography should begin earlier if familial breast cancer occurred at a young age, typically 10 years prior to the youngest age at presentation but generally not before 30 years of age [6]. For women who have lobular neoplasia or atypical hyperplasia diagnosed prior to 40 years of age, annual screening mammography should be performed from time of diagnosis but generally not prior to 30 years of age [38]. Early detection of second breast cancers improves survival, so patients with a personal history of breast cancer should undergo annual mammography or DBT for surveillance following breast conservation therapy [3]. Mammography With IV Contrast Data are limited regarding the use of mammography with IV contrast for breast cancer screening in intermediate- risk women. To date, published studies have predominantly included women with dense breasts and other risk factors resulting in intermediate- or high-risk profiles. Compared to mammography alone, mammography with IV contrast increases cancer detection (incremental CDR = 6.6-13 per 1,000) in women at elevated risk [57-60]. Female Breast Cancer Screening MRI Breast Without and With IV Contrast MRI has a higher CDR than mammography alone, DBT, or mammography/DBT combined with US [61-64].