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Computer-aided detection has been used to aid radiologists’ interpretation of contrast-enhanced MRI of the breast, which is sometimes used as an alternative to mammography or other screening and diagnostic tests because of its high sensitivity in detecting breast lesions, even among those in whom mammography is less accurate (e.g., younger women and those with denser breasts).

According to this assessment, many of the studies on the use of CAD with MRI of the breast mainly reported on the development of CAD systems, or testing new CAD approaches.The assessment noted that few of them evaluated commercially available CAD systems.They stated that randomized trials are needed to determine the clinical value of detecting additional disease which changes surgical treatment in women with apparently localized breast cancer.In a review on the utility of MRI for the screening and staging of breast cancer, Patani and Mokbel (2008) stated that while MRI can facilitate local staging, especially the evaluation of ipsilateral multi-centric or multi-focal lesions as well as synchronous contralateral disease that may be missed by conventional imaging; however, efficacy with respect to clinically relevant and patient oriented end-points has yet to be addressed in the context of clinical trials.This variability is an indicator that the risk models provide approximate, rather than precise, estimates of breast cancer risk.

According to ACS guidelines, each of the risk models can be used for the purpose of identifying patients who would benefit from breast MRI screening (Saslow et al, 2007).Although ultrasound is sufficient to confirm rupture of breast implants in women with symptoms, MRI may be necessary to detect intra-capsular rupture of silicone gel-filled breast implants in asymptomatic women.The sensitivity of plastic surgeons familiar with implants to diagnose rupture is 30 % compared to 89 % for MRI (Holmich et al, 2005).The 3 risk models utilize different combinations of risk factors, are derived from different data sets, and vary in the age to which they calculate cumulative breast cancer risk.As a result, they may generate different risk estimates for a given patient.The guidelines explain that all of the clinical trials screened participants with both MRI and mammography at the same time.