How can magnetic resonance imaging (MRI) help diagnose breast cancer?

There's consensus among the experts on a few aspects of breast cancer screening. Both ultrasound and magnetic resonance imaging (MRI) of the breast are unproven as widespread screening tests. They're helpful for some patients after mammography to evaluate suspicious areas in the breast, but they're not effective screening tests on their own.

Magnetic resonance imaging (MRI) may have a role in the detection and management of some breast cancers. Because of their blood supply, breast malignancies typically become brighter more quickly and more intensely than benign tissues on MR images obtained after intravenous injection of a contrast agent (gadolinium).

Many investigators report that breast MRI detects 100% of breast cancers. There are, however, many false positive MR studies in which a benign abnormality mimics a cancer. Additionally, ductal carcinoma-in-situ (the earliest form of breast cancer) is identifiable on MR images in only 50% of patients.

Magnetic resonance has been shown to be the most accurate means of evaluating breast implants for possible complications such as rupture. Its superiority over mammography and ultrasonography lies not only in its ability to provide a cross-sectional view; MRI also provides information about specific tissue characteristics.

Potential, but as-yet unproven, uses for breast MRI include: 1) imaging the "dense breast," 2) more precisely determining the extent of a cancer, 3) finding the primary tumor in node positive/mammogram negative patients, and 4) assessing for recurrence after lumpectomy.

Magnetic resonance imaging scans (MRIs) use radio waves and a large magnet to create images of areas within the body, including organs, bone, and soft tissue. The three-dimensional images tend to be very clear and may be a better option for breast cancer screening than conventional mammograms for high-risk or younger women.

MRIs do not require breast compression and thus avoid the discomfort of regular mammograms. Research has shown that MRIs may detect more tumors than regular mammograms in women with a high inherited risk of breast cancer. But because of the large number of false-positive results, MRIs are not used as a breast cancer screening test for women who are at average risk for breast cancer.

The American Cancer Society suggests that women at high risk for breast cancer have both an annual MRI and a mammogram, and that women at moderately high risk discuss the pros and cons of the breast cancer screening tests with their physicians.

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