Breast cancer MRI
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Breast cancer MRI On the Web |
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American Roentgen Ray Society Images of Breast cancer MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]{AE}} Mirdula Sharma, MBBS [2]
Overview
MRI may be performed to detect metastases of breast cancer and to determine anatomic boundaries.
Findings on MRI
MRI uses powerful magnetic forces and radio-frequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-dimensional pictures. An MRI of the breast is not routinely used to diagnose breast cancer, but may be done in certain situations to:[1]
- find the primary tumour in the breast
- MRI may be used if cancer is found in the axillary lymph nodes or if a woman has Paget disease of the nipple.
- find out the extent of cancer in the breast tissue (local disease)
- MRI may be used when test results from physical examination, mammography or ultrasound are not clear.
- better examine an abnormality found on mammography
- MRI may be used if the abnormality cannot be found with other tests, such as a clinical breast exam or breast ultrasound.
- It may also be used if the abnormality can be seen from only one view of the results of a mammography.
- check the condition of breast implants, especially if the doctor suspects that an implant has ruptured
Breast MRI may be used to study silicone implant integrity.
Tumor angiogenesis or neovascularity makes the foundation of application of MRI to detect breast cancer
Increased vasculture and hence increased permeability, increase take up and release of the contrast media and distinguish breast cancers from benign tumors
Tailored breast coil is essential for breast MRI.
application of contrast agents such as intravenous gadolinium is recommended in order to maximize cancer detection and to highlight neovascularity.
Evaluating silicone implant integrity. does not need contrast media.
Application of contrast media such as gadolinium is contraindicated in patients with renal function.
Breast MRI sensitivity is high, but the specificity is low
There is an overlap in the enhancement pattern of benign and malignant lesions.
●Hormonal changes and cancer treatments can affect the accuracy of breast MRIs. Although there is variation in the performance of breast MRIs, reporting should follow standard guidelines. Facilities that perform breast MRI should have MRI-biopsy capability. (See 'Limitations of breast MRI' above.)
●Contraindications for breast MRI include pregnancy, implanted devices and foreign bodies, and any prior history of gadolinium allergy or diminished renal function. (See 'Precautions' above.)
●The appropriate use of breast MRI is evolving and some indications remain controversial. Breast MRI has been used for the assessment of silicone implant integrity, diagnosis of occult primary breast cancers, determination of disease extent in newly diagnosed breast cancer patients (when indicated), documentation of response to neoadjuvant chemotherapy, diagnosis of recurrence, clarification of inconclusive clinical or imaging findings, and screening of high risk patients. (See 'Indications for breast MRI' above.)
References
- ↑ Breast cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/breast/signs-and-symptoms/?region=on#ixzz3xScycfqv Accessed on January 16, 2016