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Even among women at highest risk for breast cancer (those with BRCA1 or BRCA2 mutations) who undergo regular screening mammography, substantial proportions develop invasive cancers. In a systematic review of 11 prospective studies (involving about 5000 patients), researchers assessed the accuracy of combining magnetic resonance imaging with mammography for screening such women.
Among biopsy-confirmed breast cancers, sensitivity for detecting lesions that were suspicious or highly suspicious and required biopsy (American College of Radiology Breast Imaging Reporting and Data System [BI-RADS] scores of 4 or 5) was 32% for mammography alone, 75% for MRI alone, and 84% (specificity, 95%) for the tests combined. Assuming a 2% pretest probability …