Page 15 - Delaware Medical Journal - March 2018
P. 15
SCIENTIFIC ARTICLE
FIGURE 2
have biennial screening, and should continue as long as they have a reasonable expectation of ten years of life remaining. (Table 1 14
A frequently asked question, and one referenced in the mandated dense breast
or ultrasound or other imaging modalities
in addition to mammography for breast cancer screening. If tomosynthesis is the mammography technique used, most women modalities. After a PCP has determined whether genetic counseling referral is indicated and after determining lifetime
risk (LT risk) of breast cancer using the Tyrer-Cuzick tool, a woman and her PCP could refer to the Massachusetts Breast
Decision
Decision
Risk Education and Assessment Task
Force algorithm (Figure 2) for deciding if additional imaging is needed over and above annual tomosynthesis mammography.
If the lifetime risk of breast cancer (LT
Cancer Society recommends annual MRI
in addition to mammography regardless
of breast density. Women in this category include, but are not limited to, those with deleterious mutations such as BRCA 1 or BRCA 2, Li Fraumeni or Cowden’s, and women with a personal history of therapeutic mantle irradiation at or before age 30. If
a woman’s LT risk (based on the Tyrer-
imaging, regardless of breast density.
to discuss with their PCP the problems MRI or ultrasound to mammography for when it becomes palpable. The risks include having many more call backs for additional imaging, having more biopsies for benign LT risk, insurance may not cover MRI or has not been shown to outweigh the risks.
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