| h1> | | | | good at seeing everything and anything, there is a |
| | | | good chance that an abnormality will be |
| Many women want to have a breast MRI. This | | | | revealed. Afterwards, we call these benign |
| article describes the benefits and harms of such a | | | | biopsies unnecessary because the |
| test. | | | | abnormality is a false positive finding. But |
| Patients often ask me: Should I get an | | | | before the biopsy result comes back as benign, it |
| MRI? (magnetic resonance imaging). The | | | | certainly was very necessary, because no patient |
| answer from me is: Only if you need it. | | | | and definitely no doctor wants to let an |
| Why should we NOT all get breast MRI? After | | | | abnormality go unchecked. |
| all, we know that mammograms and ultrasounds | | | | The answer to who needs an MRI is not always |
| do fail to pick up some breast cancers. MRI is | | | | simple. The current guidelines advise breast MRI |
| the latest, most expensive modality in breast | | | | for the following women: |
| imaging. It’s the best, is it not? Well, | | | | 1) Lifetime breast cancer risk 25% or higher |
| clearly, the advantage of MRI is that it can see | | | | 2) BRCA (breast cancer gene) carrier |
| everything and anything. The disadvantage of | | | | 3) First-degree relative of a BRCA carrier, if the |
| MRI also is that it can see everything and | | | | first-degree is not tested for the gene |
| anything. When an abnormality is | | | | 4) Previous radiation to chest between age 10 |
| detected on MRI, sure it could turn out to be | | | | and 30 (for non-breast cancer reasons) |
| breast cancer. But it can also turn out to be one | | | | 5) New diagnosis of breast cancer |
| of the many completely benign conditions, such as | | | | 6) Silicone breast implants |
| fibroadenoma, cyst, fibrocystic, infection, breast | | | | There are certain women who may need a |
| engorgement from menses or lactation, bruising | | | | breast MRI, although these women may not |
| from trauma, scar from previous surgery or | | | | meet any of the above criteria. The decision for |
| needle biopsy, previous radiation, etc. The only | | | | a breast MRI should be made jointly with a |
| sure method of telling cancer from benign is to | | | | physician, on an individual patient basis, so that the |
| subject the patient to an invasive biopsy to obtain | | | | pros and the cons can be discussed |
| tissue from the MRI breast abnormality. So, if | | | | ahead of time. It should be emphasized that MRI |
| you want to get a breast MRI, you should be | | | | is an adjunct to mammography, not a |
| mentally prepared for the biopsy that will be | | | | replacement. Normal-risk women age 40 or |
| recommended by your doctor if the MRI shows | | | | higher should have yearly mammogram and |
| an abnormality. Because the MRI is so | | | | physical examination. |