BRCA1 and breast cancer: <i>BRCA2</i> mutation carriers are less likely to benefit from adjunct MRI screening, which implies that mammography alone would be sufficient from a cost-effectiveness perspective, regardless of dense breast cancer.<h4>Conclusions</h4>Precision screening strategies among <i>BRCA1/2</i> mutation carriers should be conducted according to the acceptable ICER, i.e., a combination of mammography and MRI for <i>BRCA1</i> mutation carriers and mammography alone for <i>BRCA2</i> mutation carriers.<h4>Systematic review registration</h4>PROSPERO, identifier CRD42020205471.