A 35-year-old BRCA1 carrier undergoing screening has dense breasts on mammography (ACR density category D). Guidelines recommend supplemental screening with:
- A Annual mammography alone is sufficient
- B Breast MRI with contrast annually ✓
- C Ultrasound every 6 months
- D CT of the chest and breasts annually
Correct answer: B. Breast MRI with contrast annually
Explanation
High-risk women (BRCA1/2 carriers, lifetime risk >20%) should undergo annual contrast-enhanced breast MRI in addition to mammography because mammography sensitivity drops to 30–40% in dense breasts, while MRI sensitivity exceeds 90% for invasive cancer. Ultrasound is an adjunct but has lower specificity and is not guideline-recommended as primary supplemental tool for BRCA carriers. CT delivers excessive radiation and lacks MRI's sensitivity.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.