5. Women with high breast density
Tailored screening with MRI
Issued on: January 2020
Healthcare question
Should tailored screening with magnetic resonance imaging, in addition to digital mammography, vs. digital mammography alone be used for early detection of breast cancer in asymptomatic women with high mammographic breast density in organised population-based screening programmes?
Recommendation
For asymptomatic women, with high mammographic breast density and a negative mammography, in the context of an organised population-based screening programme, the ECIBC's Guidelines Development Group (GDG) suggests not implementing tailored screening with magnetic resonance imaging (MRI).
Recommendation strength
| Conditional recommendation |
| Very low certainty of the evidence |
Justification
The recommendation is conditional because there is still a lot of uncertainty; costs and feasibility are still key issues. Health benefits and harms seem to be equal but there is still concern about the other factors.
Subgroup considerations
This recommendation is for the women specified in the question.
Research priorities
Not all GDG members felt that there is a need for further research. GDG members acknowledged that there are clinical trials ongoing regarding MRI-tailored screening for women with high breast density.
Research priorities included:
- Research into the balance of effects, including the potential risk of adverse events due to contrast reaction or intravenous procedures is required for MRI
- Research to improve the specificity of MRI-tailored screening
- Need to study abbreviated protocols to make the intervention less costly and more acceptable.
Supporting material