We are grateful to Santoro et al. for commenting on our paper [1]. We agree that more work is necessary to compare outcomes in high risk women screened with breast MRI compared to no intensive screening. We also agree that obtaining such a control group is increasingly difficult. We are also in agreement that the current results in terms of tumor size, lymph node status, and survival are nonetheless encouraging. We acknowledge that we had overlooked the HIBCRIT Study final results paper [2] and thank Santoro et al. for bringing this to our attention.

Yours truly,

Prof D Gareth Evans MD FRCP