The American Cancer Society recently released updated breast cancer screening guidelines that talk about the use of magnetic resonance imaging (MRI). This change marks the first time in four years that the Society has updated its recommendations on the early detection of breast cancer.

What does this mean for women seeking mammograms?

Mammography is highly effective in detecting breast cancer at an early stage and, when followed up with appropriate diagnosis and treatment, reducing mortality from breast cancer. For women at an increased risk of breast cancer, other screening technologies also may contribute to the earlier detection of breast cancer.

The Society recommends the addition of MRI screening to mammography for women at high risk of breast cancer, which includes those who:

• have a known BRCA1 or BRCA2 gene mutation

• have a first-degree relative (mother, father, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves

• have a lifetime risk of breast cancer of 20%-25% or greater, according to risk assessment tools that are based mainly on family history

• had radiation therapy to the chest when they were between the ages of 10 and 30 years

• have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives

It is also recommended that women at moderately increased risk talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Women at moderately increased risk include those who:

• have a lifetime risk of breast cancer of 15%-20%, according to risk assessment tools that are based mainly on family history

• have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)

• have extremely dense breasts or unevenly dense breasts when viewed by mammograms

While MRI is more sensitive in detecting cancers than mammograms, it also has a higher false-positive rate (where the test finds something that turns out not to be cancer), which results in more recalls and biopsies. This is why it is not recommended as a screening test for women at average risk of breast cancer, as it would result in unneeded biopsies and other tests in a large portion of these women.

The use of regular mammograms, MRI (in women at high risk), clinical breast exams, and finding and reporting breast changes early offers women the best opportunity for reducing the breast cancer death rate through early detection. This combined approach is clearly better than any one test for early detection.

If you are a woman who is 40 or older, remember to schedule your yearly mammogram. For more information about the American Cancer Society’s screening guidelines, visit www.cancer.org or call 1-800-ACS-2345 anytime, day or night. No matter who you are, we can help.