Ask the Doctor: What about Breast MRI?

Ask the Doctor with Dr. Jacqueline Napoletano, MD


Magnetic resonance imaging (MRI) uses strong magnetic fields and radio waves to produce a very precise image of the breast. MRI uses no radiation.

MRI is an adjunctive test, performed in addition to mammography and not a replacement for mammography.

In 2007, an expert panel reported new recommendations for the use of MRI screening for women at increased risk for breast cancer. The panel recommended annual screening using MRI in addition to mammography for women at high lifetime risk (20-25% or greater). Women at a moderately increased risk (15%-20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening. MRI screening is not recommended for women whose lifetime risk is less than 15%.

Indications for breast MRI include:

1. Screening in patients with a high risk of developing breast cancer (20-25% lifetime risk of breast cancer, such as women who carry the BRCA1, BRCA2 genes and women with prior chest wall radiation (such as in treatment for lymphoma).
2. In some patients with a new diagnosis of breast cancer. This is controversial as MRI in this case has potential benefits (such as finding additional cancer in the same breast or the opposite breast) but also has risks (such as leading to more biopsies that are not cancerous and also increases a woman’s chance of having a mastectomy).
3. Assess a patient’s response to chemotherapy.
4. Determine what is scar tissue versus a recurrence of cancer at site of prior surgery.
5. Evaluation for rupture in silicone breast implants.

Since breast MRI can lead to additional biopsies, the decision to have a breast MRI should be made after discussion of the benefits and the risks with your doctor.

About Dr. Napoletano

Dr. Napoletano received her Doctor of Medicine in 1989 from the Temple University School of Medicine. She currently serves as a Diagnostic Radiologist and Director of Breast Imaging at the Breast Center at the Helen F. Graham Cancer Center, Christiana Care Health System. She is a Delaware Breast Cancer Coalition (DBCC) Board Member and sits on the advisory committee for the Christiana Care Health System Center of Excellence for Women.