How do you counsel patients on the efficacy of breast cancer risk reduction strategies such as breast MRI surveillance or bilateral mastectomy for those considered high risk by polygenic risk score, pathogenic variants, and/or family history?

This is a difficult question with limited data to guide decisions. The ultimate goal of any screening effort is to identify disease earlier so that treatment is more effective (and hopefully less onerous) so that fewer patients die. We have good data that enhanced screening in high risk populations,...

There are currently no randomized controlled trials of breast MRI screening among women at high risk for breast cancer demonstrating a breast cancer-specific or overall survival benefit. Recent breast MRI screening trials (DENSE, FaMRIsc, EA1141) have demonstrated that supplemental breast MRI screen...

Enhanced surveillance strategies do not prevent cancer, rather, the goal is early detection. Unlike management of ovarian cancer in BRCA1/2 mutation carriers (for example), in which early detection does not work, most cancers are caught at a late stage, and most women with late-stage ovarian cancer ...