Challenges and Changes of the Breast Cancer Screening Paradigm

J Magn Reson Imaging. 2023 Mar;57(3):706-726. doi: 10.1002/jmri.28495. Epub 2022 Nov 9.

Abstract

Since four decades mammography is used for early breast cancer detection in asymptomatic women and still remains the gold standard imaging modality. However, population screening programs can be personalized and women can be divided into different groups based on risk factors and personal preferences. The availability of new and evolving imaging modalities, for example, digital breast tomosynthesis, dynamic-contrast-enhanced magnetic resonance imaging (MRI), abbreviated MRI protocols, diffusion-weighted MRI, and contrast-enhanced mammography leads to new challenges and perspectives regarding the feasibility and potential harms of breast cancer screening. The aim of this review is to discuss the current guidelines for different risk groups, to analyze the recent published studies about the diagnostic performance of the imaging modalities and to discuss new developments and future perspectives. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 6.

Keywords: abbreviated MRI protocols; breast cancer; cancer screening; contrast-enhanced mammography; digital breast tomosynthesis; magnetic resonance imaging; ultrasound.

Publication types

  • Review

MeSH terms

  • Breast / diagnostic imaging
  • Breast / pathology
  • Breast Neoplasms* / pathology
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Mammography / methods
  • Mass Screening