Magnetic resonance imaging (MRI) is a non-invasive advanced medical imaging technique utilizing a magnetic field, radio waves and a computer to produce detailed three-dimensional images of the breast. Breast MRI is most effective when used in conjunction with a mammogram. Breast MRI is not a replacement for annual mammography as it cannot image microcalcifications that can indicate early breast cancers.
Screening Breast MRI
The American Cancer Society recommends screening breast MRI for:
- Women with BRCA 1 or BRCA 2 gene mutations
- Women with a first degree relative with BRCA 1 or BRCA 2 gene mutations who have not as yet had genetic testing
- Women with a lifetime risk of more than 25% as defined by risk assessment tools largely dependent on family history
- Women who underwent radiation to the chest between ages 10-30 for Hodgkins disease
- Women known to have a hereditary breast cancer syndrome, i.e. Li Fraumeni, Cowden and Bannayan-Riley-Ruvalcabo and their first degree relatives
Screening breast MRI in women at moderate risk, a lifetime risk of 15-24%, is controversial and these women should consult with their doctor. This includes women with LCIS (lobular carcinoma in-situ), ALH (atypical lobular hyperplasia), ADH (atypical ductal hyperplasia), heterogeneously or extremely dense breasts on mammography, and personal history of breast cancer including DCIS (ductal carcinoma in-situ).
Breast MRI has been shown to be very useful in monitoring the opposite breast in women who have been newly diagnosed with breast cancer.
Diagnostic Breast MRI
Breast MRI may be indicated in the following settings:
- Determining the local extent of breast cancer
- Monitor response to neoadjuvant chemotherapy
- Local recurrence detection after breast conservation
- Detection of an occult breast cancer
- When other breast imaging tests are not conclusive
- Silicone implant evaluation
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