1. BRCA mutation

            2. First-degree relative of BRCA carrier, but untested

            3. Lifetime risk ~20-25% or greater, as defined by BRCAPRO or

               other models that are largely dependent on family history

            4. Radiation to chest between age 10 and 20 years

            5. Li-Fraumeni syndrome and first degree relatives

            6. Cowden and Bannayan-Riley-Ruvalcaba syndromes and first-

               degree relatives

      Patients should understand that your  insurance company will usually require that you  meet any deductible first, and then pay the policy's co-pay, before the insurance benefits will pay.

       We still recommend that screening breast ultrasound be done for average-risk patients with mammographically dense breasts, and that MRI is not needed in these patients. Screening MRI should be done for the high-risk patients (per ACS guidelines), and breast ultrasound then would not be necessary in these patients, even if mammographically dense. Mammography should be done for all patients, regardless of risk level, and regardless of whether they have ultrasound or MRI as well.

 High risk (meeting ACS guidelines) = mammogram and MRI