All women in the U.K. known to carry BRCA1 or BRCA2 are offered higher risk breast screening from age 30 with annual MRI breast screening. From age 40 years, digital mammography is also performed each year.

Once a woman is 50 years, the radiologist will decide how dense the breast tissue is and whether annual MRI is still required in addition to annual mammograms. Women will continue to be offered annual mammograms for the rest of their lives.

If a woman has had risk reducing surgery removing all the breast tissue surveillance MRI and mammograms are no longer required.

MRI (MAGNETIC RESONANCE IMAGING) breast screening

Breast MRI is not recommended as a routine screening tool for women in the general population but is often used to gain further information when women are diagnosed with breast cancer. However, it is recommended for screening women who are at high risk for breast cancer including those with BRCA1 and BRCA2 mutations.

Breast MRI is not a perfect tool, although it is generally considered more sensitive for picking up breast cancer than mammography especially in younger women and women with dense breasts.

An MRI scan is an imaging procedure, which uses magnetic fields and radio waves to take pictures of your body. The scanner is a large tunnel, which is open at both ends and is well lit and ventilated.

It is important that you tell the radiographer if you have any metal inside your body as the metal would move with the magnetic field. A small cannula or tube is inserted into a vein in your arm, which will allow dye to be injected. This dye will help to show any abnormalities in your breast tissue more clearly. You will be asked to lie down on the scanning bed allowing your breasts to rest in the cushioned holes provided.

A “call-bell” will be given to you so that you can contact the radiographer at any time. The machine makes a loud banging noise when taking the images. Earplugs or headphones are provided to minimize this. The whole imaging procedure usually lasts between 30 minutes and one hour. You should not feel anything during the procedure and you will be able to leave the department immediately afterward.

 

Digital mammography

Mammograms are probably the most important tool doctors have not only for breast screening but also to diagnose, evaluate breast cancer, and follow people who’ve had breast cancer. The technique has been in use for more than 50 years and is safe using low energy x-rays to examine the breasts. In recent years the introduction of digital mammograms allows the images to be stored directly on to a computer.  The images are high quality and the dose of radiation used is even smaller. Digital mammography has been proven to be of particular benefit for screening women under 50 years old and those with dense breast tissue.

A mammogram takes a few seconds to perform and involves a small dose of radiation.  The radiographer will position each breast in turn on the x-ray machine and is gently compressed against a plastic plate.  Two mammograms are taken of each breast from different angles.

 

Breast Ultrasound

Ultrasound examination of the breast tissue is not recommended as a screening tool however if there is an abnomality on the MRI or

mammogram an ultrasound may be used. An ultrasound sends harmless high-frequency sound waves through the breast abd converts then into images on a screen. This is often the best way to find out if an abnormality is solid or a fluid cyst.