American Board of Internal Medicine (ABIM) Certification Practice Exam

At what age should women with BRCA1/2 mutations start MRI screening for breast cancer?

1. 20

2. 25

3. 30

4. 35

The correct answer is: 25

Women with BRCA1/2 mutations are at significantly increased risk for developing breast cancer, and due to this heightened risk, enhanced surveillance is recommended. The guidelines suggest that these women should start annual MRI screening for breast cancer at age 25. This recommendation is based on the understanding that MRI is a more sensitive imaging modality for detecting breast cancers in high-risk populations, particularly in women who may have denser breast tissue, which can obscure tumors on traditional mammography. Initiating screening at age 25 allows for early detection, which is crucial since breast cancers associated with BRCA mutations can occur at younger ages than the general population. While screening can begin as early as 25, it does not mean that every individual will have screening done at this age; clinical judgment and individual risk assessment may adjust this recommendation. However, starting at age 25 aligns with established guidelines aimed at maximizing the chances of early detection and improving outcomes for women with BRCA1/2 mutations.