Screening in women at high risk for breast cancer

     For women at high risk for breast cancer, usually because of a positive family history, MRI may be an appropriate screening tool for breast cancer. A positive family history is usually a mother or sister who had breast cancer before age 50. These can be aunts or cousins, including those on the father’s side. Relatives who have had ovarian cancer also increase the risk. Depending on family history, genetic testing may also be recommended.

• Determining tumor spread after diagnosis of breast cancer

     After a diagnosis of breast cancer, a breast MRI may be performed to determine:

• how big the cancer is and whether it involves the underlying muscle
• if there are other types of cancer in the same breast and if there is an unexpected cancer in the opposite breast
• if there are abnormally large lymph nodes in the armpit, which can be a sign that the cancer has spread to that place.
• evaluation of abnormalities observed on mammography

     Sometimes, abnormalities seen on a mammogram cannot be adequately evaluated with additional mammography and ultrasound. In these rare cases, an MRI can be used to definitively determine whether the abnormality requires a biopsy or can be safely left alone.

• Assessment of breast resection sites in the years after breast cancer treatment

     Scars and recurrent cancer can look identical on mammograms and ultrasounds. If a change in a scar from surgery is detected either by a mammogram or a physical exam, an MRI can help determine whether the change is normal scar maturation or cancer recurrence.

• After chemotherapy in patients who received neoadjuvant chemotherapy

     In some cases, breast cancer will be treated with chemotherapy before it is removed by surgery. This is called neoadjuvant chemotherapy. In these cases, MRI is often used to monitor the effect of chemotherapy.

• Evaluation of breast implants

     Magnetic resonance imaging is the best method for determining if silicone implants have ruptured.