1) Identify risk factors that alone or in combination may indicate that a patient may be at high risk for developing breast carcinoma. 2) Understand methods for calculating lifetime risk of breast carcinoma. 3) Understand current and emerging screening strategies for women at elevated risk for developing breast carcinoma.
Screening with MRI and mammography are recommended for women with >20-25% lifetime risk of breast cancer based on family history. The strongest risk factors associated with breast cancer are genetic (BRCA 1 and 2, Li-Fraumeni, Cowden, and Bannayan-Riley-Ruvalcaba Syndrome) and high radiation exposure to the breasts. Combinations of other risk factors can be evaluated for lifetime risk using comprehensive models, though use of ancillary screening is less well validated in these populations. Ultrasound is less sensitve than MRI for women at high risk. Emerging technologies, such as gamma imaging, positron emission imaging, and CT, may provide similar sensitivity and specificity examinations with lower cost though more studies are needed.
Harvey, J,
Breast Cancer Risk Assessment and Tailored Screening. Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL.
http://archive.rsna.org/2009/8001215.html
