What is breast MRI? How is it used to diagnose breast disease?
A. Breast MRI (magnetic resonance imaging) is a highly sensitive test best reserved for problem solving and screening in very high risk women. Because it is a very expensive test with variable coverage from third party payers, and because standardization of equipment, scanning protocols, and physician training does not yet exist, MRI should not be recommended at this time as a routine screening tool in women of average risk. Recent published data have suggested that MRI better evaluates the true extent of disease in patients recently diagnosed as having breast cancer in both the abnormal as well as the “normal” breast; this information can be very valuable when planning the optimal surgical and oncologic care for a patient. Women diagnosed as having infiltrating lobular carcinoma, a relatively uncommon cancer that can be difficult to detect on mammography and ultrasound, should also have bilateral MRI scans before a treatment plan is finalized.
