MRI Screening for Women at High Risk for Breast Cancer

By Christina Gougoutas-Fox, M.D., co-medical director, Ruth J. Spear Breast Center at Providence Cancer Center.

Women at high risk of developing breast cancer should receive an annual magnetic resonance imaging (MRI) scan, in addition to their yearly mammogram, beginning as early as age 30, according to guidelines published by the American Cancer Society.

Why should this select group of women receive yearly MRIs? MRI scanning is a powerful tool for detecting abnormalities in soft tissue and bones. Major research studies in recent years have indicated that up to 5 percent of cancers that are missed by mammograms and ultrasound are detectable by MRI.

Who benefits from MRI screening for breast cancer?
The American Cancer Society recommends MRI screening for any woman who meets at least one of the following criteria:

  • BRCA1 or BRCA2 mutation
  • First-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation, even if the woman has yet to be tested herself
  • Lifetime risk of breast cancer that has been scored at 20 to 25 percent or greater, based on one of several accepted risk-assessment tools that look at family history and other factors
  • Past radiation treatment to the chest between the ages of 10 and 30
  • Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or possibility of having one of these syndromes based on history in a first-degree relative

If you have questions about any of these criteria, ask your primary care physician or visit Providence Breast Centers at Providence St. Vincent Medical Center, Providence Portland Medical Center or Providence Medford Medical Center. Our breast centers are staffed by a team of nurses, physicians, diagnostic imaging experts and cancer specialists, all of whom are dedicated to breast health.

Why don’t all women receive annual MRI screening?
MRI screening is so sensitive that it detects almost all breast abnormalities, the vast majority of which are completely harmless. Screening all women might needlessly subject many healthy women to uncomfortable follow-up procedures (such as biopsies), not to mention the stress and anxiety of waiting for test results. 

Most studies indicate that an abnormality that is negative on both a mammogram and an ultrasound has less than a 5 percent chance of turning out to be cancer.

But for women with positive mammograms or ultrasounds, for women at high risk of developing breast cancer, and for women currently undergoing cancer treatment, MRI imaging at Providence offers a closer level of scrutiny and is proving to be an indispensable part of patient care.