Andrew J Spillane
The use of magnetic resonance imaging (MRI) for breast screening
is increasing. Women may approach their general practitioner for
advice on its role in breast screening and diagnosis.
This article provides an evidence based update on the role of
There is good evidence to support the use of MRI for cancer
screening in younger women at high genetic risk of breast cancer.
Its use for assessing the extent of disease in the breast after breast
cancer is diagnosed (local staging) is controversial. Certainly MRI is
more sensitive than conventional imaging for detecting multifocal/
multicentric disease, however, there is evidence that some women
have more extensive surgery as a result of MRI without clear evidence
of benefit. There is no role for MRI as a substitute for mammography
or for screening women at average risk of breast cancer. It also has
no routine role as a diagnostic test in women with symptoms.
Over the past 10 years, the use of magnetic resonance imaging (MRI) for screening and diagnosis of breast cancer has been increasing. Uses include screening in women at high genetic risk of breast cancer, evaluating the extent of disease in women with a recent diagnosis of breast cancer, and detecting synchronous contralateral cancer. Magnetic resonance imaging has high overall sensitivity and has at times been promoted as a ‘gold standard’ in breast imaging. However, its role remains controversial. Importantly, breast MRI has a high false positive rate and evidence of benefit in some clinical situations is lacking. There may be a high level of awareness of MRI among some women presenting to specialist clinics with breast symptoms. It is important that practitioners provide evidence based answers to their questions.
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