| Recommendation for Screening |
Age: How often: | 30+ Annual |
| Gender: | Female |
| Risk level: | Greater than 20% lifetime |
1. What is this exam?
This is an MRI of your breasts to look for any signs of breast cancer.
2. Why do I need this test?
There were about 209,000 new cases of breast cancer predicted and about 40,000 breast cancer deaths expected in the United States in 2010. Most doctors feel that early detection of breast cancer can be life-saving. Recently, guidelines were updated to recommend annual breast MRI to women 30 years (age recommendations vary somewhat) and older who have greater than or equal to 20% lifetime risk (or 15-20% in certain cases) for developing breast cancer according to results of breast risk assessment tools which look at primarily patient and family history. Breast cancer risk may be assessed by your healthcare provider or using a variety of online tools including, www.cancer.gov/bcrisktool/. Breast MRI is also recommended for certain other women at increased risk including those who have had radiation to the chest or those who have certain genetic syndromes.
3. How is this test done?
This test is performed in an MR scanner. You will be positioned face-down on a moveable table, which will then glide into the cylinder-shaped MR tube. The scanning procedure will then begin. You will receive an intravenous injection of contrast material at some point during the procedure. The procedure is usually completed within an hour or less. You will hear some loud repetitive noises during the exam. Some people experience claustrophobia in the MR scanner, as it is a somewhat confined space. If you think this may be a problem for you, your physician may suggest other options.
4. Are there any special instructions for this test?
You will be given special instructions before the exam. Breast MRI is usually preferred between the 7th and 14th days of the menstrual cycle. You will be asked to remove all metal for the exam, and you will be given a questionnaire to determine that you do not have any contraindications to MRI such as brain aneurysm clip, cardiac pacemaker, and numerous other metal devices. Other instructions may be given.
5. Risk factors
- Female
- Age > 40 and especially age > 50
- Personal history of breast cancer
- Family history of breast or ovarian cancer
- Gene mutations including BRCA1 and BRCA2 mutations
- Family history of male breast cancer
- Prior abnormal breast biopsy
- Ethnicity (highest incidence in Caucasians, highest death rate African-American)
- Ashkenazi Jewish ancestry
- Prior chest radiation therapy
- Menarche < 12
- Menopause > 55
- DES intake
- First child after age 30 or no children
- > 1 alcoholic beverage per day
- Obesity especially after menopause
- Hormone therapy (some controversy); strongest association in people on recent or current combined estrogen/progesterone therapy
- Sedentary lifestyle
- High fat diet (maybe)
- Many others remain controversial: anti-perspirants, pollution, night-shift work, underwire bras, induced abortion, breast implants, smoking, secondhand smoke
Citations
- "Preventative Screening Tests and Immunizations." U.S. Department of Health and Human Services. February 2011. http://www.womenshealth.gov/prevention/general/.
- "Screening for Breast Cancer." U.S. Preventive Services Task Force. July 2010. http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
- "Detailed Guide: Breast Cancer; Can Breast Cancer be Found Early?" American Cancer Society. September 2010. http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_Can_breast_cancer_be_found_early_5.asp.
- "Emerging Areas in Early Detection. " Susan G. Komen for the Cure. September 2010. http://ww5.komen.org/BreastCancer/EmergingAreasinEarlyDetection.html.
- "Estimated New Cancer Cases and Deaths by Sex, United States, 2010." CA A Cancer Journal for Clinicians: Cancer Statistics, 2010. July 2010. http://caonline.amcancersoc.org/cgi/content/full/caac.20073v1/TBL1.
- "Breast Self-Awareness" The University of Texas, MD Anderson Cancer Center. August 2009. http://www2.mdanderson.org/app/pe/index.cfm?pageName=opendoc&docid=2338.
- "Detailed Guide: Breast Cancer; What are the Risk Factors for Breast Cancer?" American Cancer Society. September 2010. http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp?rnav=cri.
- "Breast Cancer (PDQ-r) Screening." National Cancer Institute U.S. National Institutes of Health. January 2011. http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional.
- "MRI of the Breast." RadiologyInfo. February 2010. www.radiologyinfo.org/en/info.cfm?pg=breastmr.
- "Breast MRI: Imaging test to detect breast cancer." MayoClinic. July 2009. www.mayoclinic.com/health/breast-mri/BR00019.
- "Frequently Asked Questions about MQSA." U.S. Food and Drug Administration. October 2009. http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/ConsumerInformation/ucm113968.htm.
- "Mammography." Radiology Info: The Radiology Information Resource for Patients. March 2010. www.radiologyinfo.org/en/info.cfm?pg=mammo&bhcp=1.
- "Breast Cancer Risk and Risk Factors." Breastcancer.org. January 2011. http://www.breastcancer.org/symptoms/understand_bc/risk/.
Created: 8/5/2007
Last Modified: 4/7/2011