full free access: Editorial: Early Diagnosis of Hereditary Breast Cancer by Magnetic Resonance Imaging: What Is Realistic?

"....With respect to future perspectives, studies on tumor recurrence and mortality are important. All studies have shown that early detection of breast cancer, especially by MRI screening, is realistic, although only the Dutch and Norwegian studies had (nonrandomized) control groups. However, a downward shift of stage as a surrogate end point does not guarantee a survival benefit due to potential lead time and length time bias. Therefore, and in few of the absence of randomized trials, large prospective observational studies with long-term follow-up ( 10 years) are needed to describe concrete survival effects on mortality reduction by screening, rather than rely on outcomes calculated by computer models based on tumor stage. Furthermore, the (potential) long-term adverse effects of yearly MRI screening for longer than 25 to 35 years from the age of 25 to 30 have to be evaluated, especially in regard to possible development of contrast-induced nephropathy."