Imaging in breast cancer
What role should MRI play in breast cancer screening and management?
The increasing use of magnetic resonance imaging in breast cancer screening and management of early breast cancer is a ‘hot-button' issue.
Superficially, it sounds like a good idea. MRI of the breast is a highly sensitive test, especially useful in uncommon clinical scenarios such as Paget's disease of the breast or occult primaries.
In high-risk patients with BRCA1 and BRCA2 gene mutations, detection of malignant breast lesions increases from 25-59% with mammography alone to 80-100% when combined with MRI.1
Annual MRI screening among BRCA carriers detects more interval cancers and more earlier-stage cancers (ductal carcinoma in situ and stage I carcinoma, 13.8% with MRI vs 7.2% without MRI).2
Adding annual MRI screening to mammography also results in 70%