Who should get a breast magnetic resonance imaging (MRI) test?

In accordance with guidelines set forth by the American Cancer Society, we recommend that women with a lifetime risk for developing breast cancer greater than 20 percent get an MRI in addition to their mammogram every year. Women with a 15-20 percent lifetime risk should discuss MRI screening with their doctors. The ACS does not recommend MRI screening for those with a lifetime risk less than 15 percent. 

As a screening tool, magnetic resonance imaging (MRI) is most appropriate for patients at high risk. This category includes women who have at least a 20-25 percent chance of developing breast cancer: 

  • Those with mutations of BRCA1/2 genes
  • Women who have Hodgkin's disease and have had radiation to the thorax
  • Women with a family history of breast cancer in a first-degree relative (mother, daughter, sister)
  • Women who have had breast cancer
  • In some cases, women with biopsy-proven high-risk lesions may be considered for MRI
Dr. Thomas M. Cink, MD

Most women need only a standard mammogram, but some should have a breast MRI. In this video, Dr. Thomas Cink describes who needs this extra exam.

Dr. Cary Hsu, MD

Current guidelines for magnetic resonance imaging (MRI) screening for breast cancer show that if you have a lifetime risk of over 20 percent for breast cancer you may be a good candidate for breast MRI. If you are a BCRA mutation carrier who chooses not to have a mastectomy or are related to a BCRA mutation carrier, then you are also a candidate for breast MRI.

Doctors agree that women who had radiation therapy between the ages of 10 and 30 are also at significant risk. People who have Li-Fraumeni syndrome or have a relative with Li-Fraumeni syndrome may be candidates as well. The same can be said for those who have, or have relatives with, Cowden or Bannayan-Riley-Ruvalcaba syndromes.

MRI is effective for younger, high-risk patients. A recent American College of Radiology Imaging Network study of high-risk women newly diagnosed with breast cancer found that adding the MRI scan to mammography led to the detection of more than 90 percent of cancers in the opposite breast missed by mammography.

Earlier detection of more extensive cancer can mean less chemotherapy and breast cancer—related surgery for many women.

Breast magnetic resonance imaging (MRI) is used to evaluate patients who are high risk based on their family history, BRCA carriers, patients with suspected implant rupture, and to evaluate for occult breast cancer. Some centers use breast MRI on all newly diagnosed breast cancers but this is controversial.  MRI is also used to evaluate response to neoadjuvant chemotherapy.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.