A 30-year-old woman is found to have a BRCA2 pathogenic variant. She desires future pregnancy. She has not been diagnosed with breast cancer. At what age should she begin MRI screening of the breast according to NICE/NCCN guidelines?
- A At age 40 years — same as general population mammography start age
- B At age 25 years, or 10 years before the youngest first-degree relative's age at diagnosis, whichever is earlier ✓
- C At age 18 years — screening begins at adulthood
- D No screening — risk-reducing mastectomy is the only option
Correct answer: B. At age 25 years, or 10 years before the youngest first-degree relative's age at diagnosis, whichever is earlier
Explanation
NICE (2019) and NCCN guidelines recommend annual breast MRI (with mammography) starting at age 25 for BRCA1/2 mutation carriers, or 10 years before the youngest affected first-degree relative, whichever is sooner. MRI is preferred over mammography alone in carriers because of higher sensitivity for dense, young breasts and BRCA-associated tumour biology.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.