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Breast MRI: Cancer Screening for Women With Increased Breast Density

  • Authors: Emily F. Conant, MD
  • CME / ABIM MOC Released: 5/21/2021
  • Valid for credit through: 5/21/2022
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Target Audience and Goal Statement

This activity is intended for obstetrician gynecologists (Ob/Gyns), women's health specialists, primary care physicians (PCPs), and radiologists.

The goal of this activity is to educate healthcare providers on the current guidelines for screening patients at high risk for breast cancer and how to counsel high-risk patients about the pros and cons of breast cancer screening options.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Screening guidelines for patients with dense breasts and average risk

    • Benefits of using magnetic resonance imaging (MRI) in breast cancer screening


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  • Emily F. Conant, MD

    Division Chief, Breast Imaging
    Vice Chair Faculty Development Radiology
    Professor of Radiology, Department of Radiology
    Perelman School of Medicine, University of Pennsylvania
    Philadelphia, Pennsylvania


    Disclosure: Emily F. Conant, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Hologic; iCAD
    Served as a speaker or a member of a speakers bureau for: Aunt Minnie; Hologic; iCAD
    Received grants for clinical research from: Hologic; iCAD


  • Victoria Phoenix, BS

    Medical Education Director, Medscape, LLC 


    Disclosure: Vickie Phoenix, BS, has disclosed no relevant financial relationships.  

  • Tristin Abair, PhD

    Senior Medical Writer, Medscape, LLC


    Disclosure: Tristin Abair, PhD, has disclosed no relevant financial relationships

CME Reviewer

  • Esther Nyarko, PharmD

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Disclosure: Esther Nyarko, PharmD, has disclosed no relevant financial relationships.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

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Breast MRI: Cancer Screening for Women With Increased Breast Density

Authors: Emily F. Conant, MDFaculty and Disclosures

CME / ABIM MOC Released: 5/21/2021

Valid for credit through: 5/21/2022



Carrie is a 46-year-old middle school teacher who recently had her first baseline breast cancer screening with digital mammography based on recommendations from her primary care physician. She subsequently received a letter indicating that no abnormalities were found by mammography and informing her that she had heterogeneously dense breast tissue, BI-RADS® density category C. The letter indicated that she should speak with her doctor regarding the effect of her breast density on breast cancer risk and optimal screening. She called her Ob/Gyn with several questions and a telemedicine visit was scheduled to address her questions and determine the appropriate next steps. 

Dr Roberts: Hello Carrie, can you hear me okay?

Carrie: Hi Dr Roberts. Yes, I can see and hear you just fine.

Dr Roberts: Great. It's good to see you again, even if it's not in person. How are you doing?

Carrie: I'm good. Spring is a busy time for our family and at school, so I'm running to keep up with everything.

Dr Roberts: I understand and can certainly relate. Spring is definitely full of activity! My nurse told me that you called the office and had questions about the results of your screening mammogram. I felt like a video call would be best to give us time to discuss your questions and concerns.

Carrie: Absolutely, thank you for taking the time to speak with me. I got a letter in the mail after my mammogram and I am confused about what it means and what should happen next.

Dr Roberts: Before we discuss the letter, let's back up and discuss your history if that's okay?

Carrie: Yes, that's fine.

Dr Roberts: Do you have any history of cancer in your family?

Carrie: Yes, my grandmother on my father's side passed away from breast cancer when I was a little girl. My dad has also had some skin cancers removed from his face and arms. He told me they weren't melanoma, they were some sort of slow growing spots. I can't remember exactly what he called them.

Dr Roberts: Perhaps basal cell carcinomas?

Carrie: Yes, that's right. Basal cell carcinomas.

Dr Roberts: What about your grandmother? Do you know how old she was when she was diagnosed?

Carrie: No, I'm not sure how old she was. I would guess she was in her late 50s when she passed away. My father doesn't talk about it much.

Dr Roberts: Okay, I understand. Let's meet at a future time to get a more detailed family history and decide if the family history increases your risks of breast cancer. I looked at your mammogram and saw that no abnormalities were found.

Carrie: That's right. But I got a letter saying I have dense breasts and I'm not sure what that means.

Dr Roberts: That's correct, the radiologist classified your breast tissue as heterogeneously dense, which means some of the tissue is considered fatty and some is dense.

Carrie: I'm assuming I received that letter because my breast density is important. What does it mean specifically for me?

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