What is breast magnetic resonance imaging (MRI)?
Breast magnetic resonance imaging (MRI) uses magnetic fields to create an image of the breast.
Breast MRI is more invasive than mammography because a contrast agent is given through an IV before the procedure.
At this time, breast MRI is mostly used in breast cancer diagnosis and staging. It is also used in breast cancer screening for women at higher risk.
Learn more about breast MRI and the diagnosis of breast cancer.
Breast MRI and breast cancer screening for women at higher risk of breast cancer
There is growing evidence that mammography plus breast MRI, compared to mammography alone, can increase detection of breast cancer in [46-48]:
For women at higher risk of breast cancer
The National Comprehensive Cancer Network (NCCN) recommends yearly screening with mammography plus breast MRI for some women at higher risk of breast cancer, including women with [15]:
- A BRCA1 or BRCA2 mutation
- A first-degree relative with a BRCA1/2 mutation, but personally have not been tested for BRCA1/2 mutations
- Radiation treatment to the chest area between ages 10-30
- Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome (or a TP53 or PTEN gene mutation)
- An ATM, CHEK2 or PALB2 gene mutation
- A greater than 20 percent lifetime risk of invasive breast cancer based mainly on family history (Estimate your lifetime risk or learn more about risk.)
Both the NCCN and the American Cancer Society (ACS) recommend women at higher risk of breast cancer begin screening at an earlier age than women at average risk [14-15]. Figure 3.5 and Figure 3.6 outline their guidelines.
Talk with your health care provider about breast cancer screening. Together, you can make a screening plan that is right for you.
Breast MRI for women with a personal history of breast cancer
Some studies suggest for women diagnosed with cancer in one breast, mammography plus breast MRI can find breast cancer in the opposite (contralateral) breast better than mammography alone [57-58].
At this time, NCCN recommends breast MRI only be considered for women with a history of breast cancer who have a greater than 20 percent lifetime risk of a second primary breast cancer due to an inherited gene mutation or strong family history of breast cancer [59].
Breast MRI for women with dense breast tissue
Mammography plus breast MRI is under study for screening in women with dense breast tissue [49,60-61].
When added to mammography, breast MRI may find a few more breasts cancer than mammography alone [62]. However, adding breast MRI increases false positive results and it is unclear whether it improves breast cancer outcomes [62].
Both the NCCN and ACS feel there is not enough evidence to make a recommendation for or against MRI screening for women who have dense breasts [14-15].
Learn more about breast density on a mammogram.
Timing of breast MRI screening
For premenopausal women, the best timing for breast MRI is day 7-15 of the menstrual cycle [15].
There is no recommended timing for breast MRI for women after menopause.
Insurance coverage of breast MRI screening
Insurance coverage of breast MRI varies.
You may wish to talk with your insurance provider before getting breast MRI screening to see if it is covered.
Breast MRI and breast cancer screening for women at average risk of breast cancer
Screening with mammography plus breast MRI is not recommended for women at average risk of breast cancer.
Researchers are studying whether screening with breast MRI can benefit women at average risk.
Screening with breast MRI has some drawbacks.
- Breast MRI is more invasive than mammography because a contrast agent is given through an IV before the procedure. In rare cases, women can have a reaction to the contrast agent.
- Breast MRI has more false positive results than mammography.
- Some MRI centers cannot do an MRI of the breast or they do not have radiologists specially-trained to read MRI images of the breast.
- Not all centers can do an MRI-guided biopsy to follow-up on an abnormal finding that can only be seen on a breast MRI (cannot be seen with other imaging such as mammography).
- Breast MRI is expensive and not always covered by insurance.
Learn more about false positive results.
Learn more about breast MRI and the diagnosis of breast cancer.