MRI and Breast Disease

Kelly Biggs, M.D.

MRI is a supplemental imaging tool for detecting breast disease.  When intravenous contrast is given to a patient, MRI is extremely sensitive in detecting enhancing breast lesions that may be cancer.  For this reason MRI is valuable in problem solving when mammography and ultrasound fail to provide a definite answer for an abnormality.  Some surgeons use MRI to determine the extent of disease in women who have already been diagnosed with breast cancer.  MRI is an acceptable screening tool for women who are at a greater than average risk for developing breast cancer due to gene mutations, certain medical syndromes, or prior therapeutic radiation treatment.  MRI is the imaging tool of choice for evaluating the integrity of silicone breast implants.

MRI does have limitations, and it should not be considered superior or even comparable to other types of imaging.  Cancers enhance when contrast is given, but so do many other benign breast structures.  Thus, if used as a screening tool for all women, the number of false positive benign biopsies would increase dramatically.  Moreover, MRI is currently too expensive and too time consuming to be an effective screening tool for everyone.  While a mammogram may take just a few minutes to complete, an MRI is usually a 30-60 minute process.

It’s important to be aware of breast MRI, but most women will never need one.  Most routine breast cancer screening can be performed effectively with mammography, and most diagnostic imaging (to address a specific abnormality) can be achieved with mammography and ultrasound.