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Abstract
Genetically predisposed women often develop breast cancer when young and when dense
breast tissue reduces the sensitivity of X-ray mammography (XRM). A UK multicentre
study comparing the performance of contrast enhanced magnetic resonance imaging (CE
MRI) with XRM in these women commenced in 1997 and reported 2005. In this multicentre
study, CE MRI was significantly more sensitive than XRM in cancer detection for the
entire cohort, but especially in the subgroup of BRCA1 carriers. Specificity for both
procedures was acceptable. Despite a high proportion of Grade 3 tumours, the tumours
were small and few women were node-positive. These findings resemble the results from
the Netherlands six-centre MRISC study and a single-centre study from Toronto. These
studies give support for a policy of annual screening combining CE MRI and XRM, which
would detect most tumours in this risk group. These studies show evidence of effective
small cancer detection, but do not have sufficient power to show whether mortality
is reduced, for which there is no current evidence.