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Breast MRI
Aka: Breast MRI, Magnetic Resonance Imaging of the Breast
- Indications
- Breast Cancer Screening in high risk women
- BRCA1 or BRCA2 genetic mutation
- First degree relative with BRCA1 or BRCA2
- Radiation exposure to chest under age 30 years
- Lifetime Breast Cancer risk estimated >20%
- Other Genetic Syndromes (and an affected 1d relative)
- Li-Fraumeni Syndrome
- Cowden syndrome
- Bannayan-Riley-Ruvalcaba Syndrome
- References
- Saslow (2007) CA Cancer J Clin 57: 75-89 [PubMed]
- Breast Cancer evaluation
- Define extent of Breast Cancer index lesion
- Identify concurrent cancer in contralateral Breast
- Assess response to Chemotherapy
- Define new Breast Cancers in those with implants
- Assess for suspected residual cancer post-surgery
- Inconclusive Mammogram, breast Ultrasound, CBE
- References
- Silverstein (2005) J Am Coll Surg 201:586-97 [PubMed]
- Protocol: Breast Cancer Screening
- Annual Breast MRI starting at age 30 in high risk women (for indications as above)
- Continue Mammograms and Clinical Breast Exams
- Efficacy: Breast Cancer Screening
- Test Sensitivity: 79% (Mammogram: as low as 33%)
- Test Specificity: 90% (Mammogram: 95%)
- Higher risk of False Positives than Mammogram
- References
- Kriege (2004) N Engl J Med 351:427-37 [PubMed]
- Kuhl (2005) J Clin Oncol 23:8469-76 [PubMed]
- Disadvantages: Breast Cancer Screening
- Too expensive for general population screening
- Twice the False Positive Rate (10%) compared with Mammogram (5%)
- Would substantially increase unnecessary testing if MRI applied to general population screening
- Resources
- Breast Cancer Risk Assessment Tool
- https://bcrisktool.cancer.gov/
- References
- Salzman (2019) Am Fam Physician 99(8): 505-14 [PubMed]