Update on Screening Breast MRI in High-Risk Women

Breast cancer is a major health problem in Europe and the United States. At the moment, 1 in 8 women in the Western European countries develops breast cancer during her lifetime, and approximately 30% of these women die of the disease. Although a nationwide screening program for breast cancer has shown a mortality reduction of approximately 1.2% annually in the Netherlands, mammography has a limited sensitivity especially in the dense breast, and cancers are missed at screening.(1,2) In women with an increased risk for breast cancer, mammographic results are even more disappointing because in many cases these women are young, and younger women have often more dense breasts than postmenopausal women. The first results regarding breast cancer screening with MRI were published by Tilanus-Linthorst and colleagues(3) in 2000. In this series, MRI detected, in 3% of the cases, a malignancy not seen on conventional imaging. After that publication, many studies were published showing the value of screening with MRI and mammography compared with screening with mammography alone in the group of women with an increased risk for breast cancer.