The American College of Radiology recently composed a list of guidelines to follow when considering a breast MRI. “Magnetic resonance imaging (MRI) of the breast is a useful tool for the detection and characterization of breast disease, assessment of local extent of the disease, evaluation of treatment response, and guidance for biopsy and localization.”
Screening: Specifically high-risk patients can benefit from this screening. Breast MRIs are often used as surveillance for women with a 20% lifetime risk or more of breast cancer based on their genetics.
It’s important to understand that a screening MRI may not reduce mortality, but the MRI screening may improve odds of early detection, allowing patients to start treatment earlier, thereby increasing survival rates.
The MRI scan is also more suited for patients with breast implants who would normally have difficulty with a mammography.
Extent of Disease: Generally, “MRI determines the extent of disease more accurately than standard mammography and physical examination in many patients.”
Breast MRIs can be used before, during, and/or after chemotherapy as well. The scan can help evaluate the treatment and how the body is responding as well as detect any residual disease.
Other Findings: Breast MRI scans can be useful to detect the recurrence of breast cancer (when other scans are inconclusive) and detecting cancers whose primary location is unknown.
Clinical trials demonstrate that a breast MRI can locate breast cancer in over half of women where the mass cannot be seen with conventional mammography.
Breast MRI scans can also help characterize lesions when biopsy cannot be performed or help for a MRI-guided biopsy.
However: It’s important to remember that a breast MRI…
- Is not recommended for the general population
- Can cause a false positive, which is why an initial biopsy confirmation is suggested
- Should not supplement mammography and ultrasound scans as diagnostic procedures
- “Documentation that satisfies medical necessity includes 1) signs and symptoms and/or 2) relevant history (including known diagnoses).”
If you would like more information on breast MRI scans, you can read more from the American College of Radiology.