Radiology alliance for health services researchBreast MRI for Cancer Detection and Characterization: A Review of Evidence-Based Clinical Applications
Section snippets
Background
MRI of the breast was initially performed nearly 30 years ago as some of the earliest imaging of the body using this diagnostic technique (2). Subsequent investigation clarified the need for the use of contrast agents such as gadolinium to discriminate benign from malignant breast tissue and refined the techniques for obtaining consistent and high quality breast MRI. There is now broad agreement that breast MRI requires high temporal and spatial resolution, and that both morphologic and kinetic
Screening Patients at High Risk for Breast Cancer
Ten studies have evaluated the use of breast MRI for screening of women at high risk for breast cancer (3, 4, 5, 6, 7, 8, 9, 10, 11, 12). The patient populations have varied, but the majority of investigations included women at risk because of a known genetic mutation or those with a greater than 25% lifetime risk based primarily on family history. The results of these studies are summarized in Table 1. MRI consistently demonstrates higher sensitivity (reported range of 71%–100%) for detecting
Problem Solving for Clinical or Mammographic Findings
There are sparse data to support the use of breast MRI as a problem solving tool for challenging or equivocal mammographic findings. Similarly, there is a lack of evidence for breast MRI evaluation of suspicious clinical findings following a negative conventional workup with mammography and ultrasound. Bluemke et al studied the diagnostic accuracy of breast MRI in 821 patients with a suspicious mammographic finding (85%) or a suspicious clinical finding with a negative or benign conventional
Future of breast MRI
The field of breast MRI is rapidly advancing, and several new techniques hold promise for improving diagnostic accuracy and assessment of response to treatment.
Conclusions
Breast MRI has been demonstrated in multiple studies to be a valuable tool for the detection and characterization of breast carcinoma. Understanding the evidence-supported benefits and potential harms of breast MRI is important to ensure the appropriate utilization of this medical resource.
MRI of the breast has been shown to be advantageous when used for screening patients at high risk, evaluating patients with a new breast cancer diagnosis, monitoring treatment response in patients undergoing
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