Screening for breast cancer in high-risk patients - MRI or mammogram?

Emmy-award-winning actress Julia Louis-Dreyfus was recently diagnosed with breast cancer and announced it using a startling statistic: “One in eight women get breast cancer. Today, I’m the one.”

This is just one of many statistics regarding breast cancer and during the month of October, Breast Cancer Awareness Month, many women (and men) will educate themselves further on breast cancer. One area of focus is screening and risk factors. For example, more than 40 percent of women age 40 and older are estimated to have dense breasts. And, according to the Journal of the National Cancer Institutewomen with dense breast tissue are four to five times more likely to get breast cancer than women who do not. 

The American College of Radiology guidelines recommend annual screenings at the age of 40 - but what screening is best for detection? Mammograms? MRI? There is a lot of confusion about risk factors for breast cancer and many articles that support women at high-risk getting an MRI annually.

What are the factors that increase risk of breast cancer?

  • A BRCA1 or BRCA2 gene mutation
  • A strong family history of breast cancer, such as a mother and/or sister diagnosed at a
  • younger age
  • A personal history of invasive breast cancer or ductal carcinoma in situ (DCIS)
  • A personal history of lobular carcinoma in situ (LCIS) or atypical hyperplasia
  • Radiation treatment to the chest area between ages 10-30
  • Li-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome (or
  • a TP53 or PTEN gene mutation)
  • Dense breast tissue
  • An ATM, CHEK2 or PALB2 gene mutation

Annual Screening MRI for Breast Cancer

Shields MRI is shedding light on what the experts REALLY say about women at high-risk and recommendations on when to get an annual MRI screening. Despite some variance, these medical organizations affirm that if you show one of these factors that put you are at higher risk for breast cancer, annual screening MRIs are often recommended.

Shields offers breast MRI services at fifteen locations throughout our network including: Brighton, Brockton, Dartmouth, Greenfield, Hyannis, Leominster, Lowell, Marlborough, New Bedford, Newburyport, Palmer, Springfield, Weymouth, Woburn, WorcesterTo make an appointment, call 1-800-258-4674.

Risk Factors

Are Annual Screening MRI Recommended?

American College of Radiology

National Comprehensive Cancer Network

American Cancer Society

BRCA1 or BRCA2 mutation carriers, untested first-degree relatives of BRCA mutation carrier


Annual mammogram and annual MRI starting by age 30 but not before age 25.

Recommended every year starting ages 30; ages 25-30, recommended every year ( if MRI not available, than mammogram); under 25, not recommended

Recommended every year starting at age 30 or age recommended by health care provider.

Women with ≥20% lifetime risk for breast cancer on the basis of family history


Annual MRI starting by age 30 but not before age 25, or 10 years before the age of the youngest affected relative, whichever is later (Annual mammogram also recommended)

Every year starting 10 years younger than the youngest breast cancer case in the family (but not younger than 30)

Every year starting at age 30 or age recommended by health care provider

History of chest radiation


Annual MRI starting 8 years after treatment(If received between the ages of 10-30); Annual mammography is also recommended, but not before age 25.

Every year, ages 25 and older; under 25, not recommended

Every year starting at age 30 or age recommended by health care provider

Li-fraumeni syndrome or TP53 gene mutation


Annual mammogram and annual MRI starting 8 years after treatment; mammography is not recommended before age 25

Ages 30 and older, recommended every year; Ages 20-29, recommended every year (if MRI not available, than mammogram)

Every year starting at age 30 or age recommended by health care provider

Personal history of breast cancer (invasive carcinoma or DCIS), ovarian cancer, or biopsy diagnosis of lobular neoplasia or ADH

Talk with your healthcare provider

Annual mammography from time of diagnosis; either annual MRI or ultrasound can also be considered.

Talk with your healthcare provider and consider starting at age 30.

Talk with your health care provider

Women with dense breasts as the only risk factor

Talk with your healthcare provider

The addition of ultrasound to screening mammography may be useful for incremental cancer detection

Talk with your healthcare provider.

Talk with your health care provider

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