Introduction
Breast MRI offers high sensitivity for cancer detection and is used for high risk screening diagnostic problem solving and preoperative staging. Dedicated breast coils dynamic contrast enhanced sequences and diffusion imaging are core components. Patient selection and standardized reporting are essential for appropriate use.
Screening and High Risk
MRI is recommended for women at high lifetime risk due to genetics or prior radiation exposure and complements mammography and ultrasound. Screening protocols emphasize high spatial and temporal resolution and consistent timing relative to menstrual cycle when applicable. Shared decision making addresses benefits and false positive rates.
Diagnostic and Preoperative Use
MRI clarifies extent of disease in dense breasts multifocal or multicentric disease and evaluates response to neoadjuvant therapy. It guides surgical planning and targeted biopsy when indicated. Correlation with mammography and ultrasound ensures comprehensive assessment.
Technical and Safety Considerations
Gadolinium contrast use requires assessment of renal function and consideration of cumulative exposure. Standardized BI RADS MRI reporting improves communication and management decisions. Quality assurance and accreditation support consistent performance.