MRI of the breast may be used to assess the integrity of breast implants and also is commonly performed prior to breast surgery to accurately stage breast cancer. This has been found to be particularly helpful as some breast tumors may be either multicentric (more than one area of primary breast cancer in the same or opposite breast) or mutlifocal (more than one primary focus in the same area of the breast). The detection of these additional foci is extremely important in planning treatment of breast cancer, for example simple lumpectomy in the case of a single focus or mastectomy in the case of more than one focus, particularly if located within the second separate area of the breast or other quadrant of the breast. Bilateral disease may also indicate the need for chemotherapy.
It has also recently been used in certain high risk patients, particularly patients with a strong family history of breast cancer as well as dense breast tissue on mammography that would substantially reduce the sensitivity of screening mammography.
MRI is currently recommended by the ACS (American Cancer Society) and approved by BC/BS in patients considered high risk:
Given the known higher sensitivity we have reduced the price of MRI breast screening to make it more available to patients who may not qualify for insurance coverage, but choose to have this study performed.
We perform complementary risk assessment at the time of screening mammography, particularly in patients with dense breast tissue and/or a significant family history of cancer. We also offer information, and in select cases, genetic testing to patients that have other cancers in the family pedigree known to be associated with an increased risk of breast cancer that may increase the likelihood of a BRCA1 or BRCA2 gene mutation. In particular, a family history of colon cancer, especially first degree relative (mother, sister, or daughter) increases the likelihood that genetic testing would result in a BRCA1 positive genetic screen, this gene mutation is associated with a much higher risk of breast CA. Breast cancer (at its earliest stage) may only be detected in these patients with screening MRI. Paternal cancers including breast cancer and even pancreatic cancer also are associated with a higher risk.