Our department of breast imaging follows breast imaging recommendations made by the American College of Radiology (ACR) and Society of Breast Imaging (SBI).
These recommendations include evaluating a patient’s lifetime risk of developing breast cancer based on the risk model calculation of your choosing. This evaluation should be done by age 30.
The ACR and SBI recommend annual screening mammogram for women age 40 and over who are at low or average lifetime risk for developing breast cancer (0% to19%). Screening should continue for as long as the patient is in good health.
Many factors can contribute to risk:
- Genetic mutations.
- Ancestry.
- Family history.
- Previous biopsy showing “high-risk” pathology.
- Chest radiation under age 30.
- Reproductive history.
- Obesity.
- Alcohol use.
- Hormone use.
- Age.
For patients that calculate at a high lifetime risk for developing breast cancer (20% or greater):
- Annual mammogram can be started as early as 30 years old.
- Extra screening with annual MRI in addition to mammogram is recommended (shown to find an additional 14 to 16 cancers per 1000 women in studies done on women with dense breasts).
- If a patient cannot undergo MRI, additional screening with ultrasound can be performed (shown to find an additional three to four cancers per 1,000 women in studies done on women with dense breasts).
- Patients with genetic mutations or very strong family history may begin annual MRI as early as 20 to 25 years old.
The ACR and SBI have recently made recommendations for supplemental screening in addition to mammogram for women with dense breast tissue. However, many insurance companies do not cover additional screening for women unless they calculate at high risk (greater than 20%). This causes recommendation difficulty for radiologists, providers and patients.
If a patient’s insurance will not cover additional screening, but it is desired by the patient, Nebraska Medicine offers a cash-pay abbreviated MRI protocol for $595. Abbreviated MRI has been shown to have similar sensitivity and specificity as a full-protocol MRI.
To refer a patient, call 402.559.2500 or fax 402.559.3464. For breast imaging questions, call Radiology at 402.559.1010.