ACR Appropriateness Criteria Breast Cancer Screening.
Mammography is the recommended method for breast cancer screening of women in the general population. However, mammography alone does not perform as well as mammography plus supplemental screening in high-risk women. Therefore, supplemental screening with MRI or ultrasound is recommended in selected high-risk populations. Screening breast MRI is recommended in women at high risk for breast cancer on the basis of family history or genetic predisposition. Ultrasound is an option for those high-risk women who cannot undergo MRI. Recent literature also supports the use of breast MRI in some women of intermediate risk, and ultrasound may be an option for intermediate-risk women with dense breasts. There is insufficient evidence to support the use of other imaging modalities, such as thermography, breast-specific gamma imaging, positron emission mammography, and optical imaging, for breast cancer screening. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
Rhode Island Hospital, Providence, Rhode Island. Electronic address: mmainiero@lifespan.org.
Martha B
MB
Mainiero
Rhode Island Hospital, Providence, Rhode Island.
Ana
A
Lourenco
University of Cincinnati, Cincinnati, Ohio.
Mary C
MC
Mahoney
Emory University Hospital, Atlanta, Georgia.
Mary S
MS
Newell
Imagimed, LLC, Rockville, Maryland; American College of Surgeons, Chicago, Illinois.
Lisa
L
Bailey
Invision Sally Jobe, Englewood, Colorado.
Lora D
LD
Barke
Emory University Hospital, Atlanta, Georgia.
Carl
C
D'Orsi
University of Virginia Medical Center, Charlottesville, Virginia.
Jennifer A
JA
Harvey
Memorial Regional Hospital, Hollywood, Florida.
Mary K
MK
Hayes
St Luke's Episcopal Hospital, Houston, Texas.
Phan Tuong
PT
Huynh
Rush Breast Imaging Center, Chicago, Illinois.
Peter M
PM
Jokich
University of Cincinnati, Cincinnati, Ohio.
Su-Ju
SJ
Lee
University of Washington, Seattle, Washington.
Constance D
CD
Lehman
University of Washington, Seattle, Washington; Society of Nuclear Medicine and Molecular Imaging, Reston, Virginia.
David A
DA
Mankoff
University of Cincinnati Medical Center, Cincinnati, Ohio.
Joshua A
JA
Nepute
Radiology Inc, Mishawaka, Indiana.
Samir B
SB
Patel
Radiology Association of Atlanta, Atlanta, Georgia.
Handel E
HE
Reynolds
Newport Diagnostic Center, Newport Beach, California.
M Linda
ML
Sutherland
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Bruce G
BG
Haffty
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000592:standards*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008495:Medical Oncology / Q000592:standards; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000592:standards*; D014481:United States
Appropriateness criteria; breast MRI; breast cancer; breast ultrasound; mammography; screening