Breast Cancer Screening with MRI – Pros without Cons

MRI Screening for Breast CancerThe social impact of breast cancer is enormous, not just because it is the most common malignancy in women and the second leading cause of cancer-related death, but also because it is sporadic in occurrence and often affects women dur­ing their most productive years. Early diagnosis and treatment lead to the most successful management of breast cancer, so public health resources have largely focused on early detection programs, including the widespread use of screening mammography.

♦ Mammography

Mammography is not the ideal screening test, however. While it can often de­mon­strate can­cers before pal­pation, about 10% of the can­cers in the Breast Cancer De­tec­tion Dem­on­stration Pro­ject study were pal­pable but not seen on mam­mo­grap­hy.1  The nega­tive pre­dictive value of mammo­graphy…

Treatment Options

A number of treat­ment options are available for patients with a diag­nosis of breast cancer. Most are based on the aggressiveness of the cancer and the extent of disease, which are difficult to determine with conventional imaging and physical examination. Most women prefer breast conservation therapy over…

♦ Lobular Carcinoma

Certain histologic types present particular problems. Lobular carcinoma accounts for only…3

♦ Ductal Carcinoma in Situ

The widespread use of mammographic screening has resulted in increased detection of ductal carcinoma in situ (DCIS). Before mammography, DCIS accounted for fewer than…

♦ Neoadjuvant Chemo­therapy

Women with larger breast cancers are now treated with neo­adjuvant or induction chemo­­the­rapy. Neoadjuvant chemo­therapy was initially confined to women with locally…

♦ Familial Breast Cancer

Familial breast cancer ac­counts for about 10% of all cases. The recent commercialization of genetic testing for breast cancer has raised new societal issues. Because the risk of breast cancer develop­ment approaches…

♦ Additional Categories

Additional categories of patients with in­creased risk of breast cancer are also being routinely imaged with…Breast MRI

Imaging Evaluation

The approaches to breast MR fall into one of two extremes, depending on the application. For staging purposes, most centers recommend…

♦ Dynamic Imaging Approach

The dynamic ap­proach sacrifices spatial res­olution for speed. Mul­tiple images are ac­quired fol­lowing…


PET using FDG and SPECT using techne­tium-99m sestamibi have been used to detect, stage, and monitor breast can­cer. These modal­i­ties take ad­vantage…


Mammography remains the method of choice for screening asymptomatic patients. For symptomatic patients with difficult mam­mograms or highly suspicious clinical findings and negative mam­mograms…

♦ Needle Biopsy

Although breast MR is often performed in Germany to improve the imaging speci­ficity prior to biopsy, this use is not wide­spread in the U.S. Needle biopsy has limited use…


This article was edited from Clinical Breast MRI by the same author. The unabridged version, including all images and references, is available at the Apple iBooks Store or see ad this page. More articles related to women’s health issues here.



  1. US Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009 Nov 17;151(10):716-26, W-236
  2. Drukteinis JS, Gombos EC, Raza S, et al. MR imaging assessment of the breast after breast conservation therapy: distinguishing benign from malignant lesions. Radiographics. 2012 Jan-Feb;32(1):219-34.
  3. Fortune-Greeley AK, Wheeler SB, Meyer AM, et al. Preoperative breast MRI and surgical outcomes in elderly women with invasive ductal and lobular carcinoma: a population-based study. Breast Cancer Res Treat. 2014 Jan;143(1):203-12.
Steven E. Harms, MD
Steven E. Harms, MD
Clinical Professor of Radiology, University of Arkansas for Medical Sciences | Faculty Page