MRI of the breasts is reserved for women at very high risk for breast cancer, such as those with genetic mutations, a history of breast irradiation, or a very high-risk family history.

MRI of the breasts is reserved for women at very high risk for breast cancer, such as those with genetic mutations, a history of breast irradiation, or a very high-risk family history.

• A. It is a first-line screening test for average-risk women.
• B. It should be used only after mammography.
• C. It is reserved for the general population with no risk factors.
• D. It is reserved for women at very high risk due to genetic mutations, prior irradiation, or very high-risk family history.

Answer: (D)

Breast MRI screening is used for those at very high risk because it has higher sensitivity than mammography and can detect cancers that might be missed on mammography, especially in dense breast tissue. Because of its higher rate of false positives and greater cost, its use is targeted to women who are most likely to benefit rather than the general population. The statement reflects current practice: MRI is reserved for women with very high risk due to genetic mutations (such as BRCA1/BRCA2 and other susceptible genes), a history of chest irradiation, or a very strong family history that places them at substantially increased risk. In these high-risk groups, MRI is typically used in addition to mammography (not as a replacement) and is followed more intensively than screening for average-risk women. This targeted approach contrasts with using MRI as a first-line test for average-risk individuals, or applying it to the general population with no risk factors.

Breast MRI screening is used for those at very high risk because it has higher sensitivity than mammography and can detect cancers that might be missed on mammography, especially in dense breast tissue. Because of its higher rate of false positives and greater cost, its use is targeted to women who are most likely to benefit rather than the general population.

The statement reflects current practice: MRI is reserved for women with very high risk due to genetic mutations (such as BRCA1/BRCA2 and other susceptible genes), a history of chest irradiation, or a very strong family history that places them at substantially increased risk. In these high-risk groups, MRI is typically used in addition to mammography (not as a replacement) and is followed more intensively than screening for average-risk women. This targeted approach contrasts with using MRI as a first-line test for average-risk individuals, or applying it to the general population with no risk factors.