The sensitivity of MRI exceeds that of mammography and MRI screening has been shown to downstage breast cancer,5–12 and there is some preliminary evidence that MRI combined with annual mammography may offer a survival advantage in BRCA2 carriers.13,14 Another option for women with a BRCA mutation is bilateral prophylactic mastectomy, which has been shown to significantly reduce breast cancer incidence in women with a BRCA mutation,15–19 but studies of prophylactic mastectomy reducing mortality are forthcoming. The gene discussed is BRCA2; the disease is breast carcinoma.