Why not have an MRI right away instead of a mammogram?
MRI is the most highly sensitive imaging study for the detection of invasive breast cancer and recent studies indicate it may also be highly sensitive for the detection of intraductal breast cancer. Although it is highly sensitive, it is not highly specific. This means that it also finds lesions which are not cancerous and leads to false positive results and subsequent biopsies. Because of its high false positive rate, high cost and the fact that it benefits from specialized expertise for interpretation, general screening of the population with breast MRI is not ready for prime time. It should be used only for specific indications, as an adjunct to mammography and breast ultrasound. At this point, MRI should be used in screening only for high risk patients.
