"Abstract

Purpose of Review

Early detection of breast cancer improves morbidity and mortality outcomes. Breast MRI remains the preferred adjunct screening modality for high-risk patients, regardless of breast density, but is not feasible for all individuals. This review evaluates alternative imaging modalities in high-risk populations unable to undergo MRI.

Recent Findings

Whole-breast ultrasound (WBUS), contrast-enhanced mammography (CEM), and molecular breast imaging (MBI) are gaining attention as alternative options to MRI. WBUS improves sensitivity in dense breasts but not to the same degree as MRI. Advancements in MBI and CEM have yielded high diagnostic accuracy approaching MRI, though evidence in high-risk cohorts remains limited.

Summary

MRI remains the gold standard as an adjunct screening tool, but alternative modalities show promise for high-risk patients unable to undergo MRI. Comparative evaluation supports their potential for broader screening integration, warranting further multi-center trials to validate effectiveness and inform guidelines."