Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer

This is a clinical practice guideline for women at very high risk of breast cancer, with ‘very high risk’ defined as: a known mutation in BRCA1, BRCA2 or other gene predisposing to a markedly elevated breast cancer risk; an untested first-degree relative of a carrier of such a gene mutation; family history consistent with a hereditary breast cancer syndrome and estimated personal lifetime cancer risk >25%; a high-risk marker on prior biopsy (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ [LCIS]); and/or radiation therapy to chest (before age 30 and at least eight years previous). The guideline discusses the use of magnetic resonance imaging (MRI) in conjunction with standard screening (mammography). Outcomes of interest include sensitivity, specificity, positive or negative predictive value, accuracy, time to diagnosis, tumour stage information (size, proportion DCIS, etc.), or improvement in patient outcome (response or survival).