How do i know whether i should get a screening mri rather than a screening mammogram?

High-Risk People: Mri is a super-sensitive test for breast cancer but is 20x more expensive than a mammogram. Therefore, it should be reserved for women who are at a high risk for developing breast cancer. This is particularly true for young women or those with very dense breast tissue on mammography, which limits the interpretation of mammograms.

High risk individual: Current guidelines recommend the following patients get screening MRI in addition to screening mammogram. 1. Brca mutation 2. First-degree relative of a brca carrier 3. Lifetime risk of breast cancer is 20-25% or greater 4. Radiation to chest between age 10-30 5. Li-fraumeni syndrome, or a first-deg relative 6. Cowden syndrome, or a first-deg relative 7. Bannayan-riley-ruvalcaba syndrome.

Screening mammo: is the standard of care. Screening MRI may be appropriate in special situations, but is not indicated for average risk patients, and unlikely to be approved by insurance plan.