When Should Women Receive a Breast MRI?

Tuesday, September 30, 2014

Every woman knows she needs to start getting regular mammograms when she reaches a certain age. But women often know less about when they should consider a breast MRI scan.

"It's important to remember that the main screening procedure for breast cancer is still a mammogram," said Dr. Linda Griska, Director of Breast Health at Abington Health. "But in some cases, other screenings may help complement the mammography."

"The American College of Radiology has carefully outlined indications for breast MRIs," said Dr. Griska. "Most often, breast MRIs are recommended for high-risk patients, such as those with the BRCA 1 or 2 gene mutations or women with a lifetime risk of breast cancer of about 20 to 25 percent."

Dr. Griska also said breast MRIs may be recommended for women with breast cancer who need to determine the extent of the disease or to determine the cause of any abnormal lymph nodes under the arm.

While the list goes on, Dr. Griska also said that even though a breast MRI may be helpful, they're not typically recommended for most patients. Before a doctor resorts to an MRI for additional imaging, they'll likely perform a breast ultrasound instead.

"Ultrasound is more commonly recommended than breast MRIs," Dr. Griska said. "There are things that the ultrasound can pick up that the mammography misses."

Although it should never replace a mammogram, ultrasound can help doctors determine whether a breast lump is a cyst or a solid mass. It's also less costly and will more often be covered by insurance than a breast MRI, if medically indicated.

While breast MRIs and ultrasounds can be effective ways to identify or screen for cancer, mammograms are the way to go.

A mammogram, which is an x-ray of the breast, is used to either screen for abnormalities or diagnose breast disease in women. It's also the best cancer screening tool currently out there; mammography has helped reduce breast cancer mortality by almost a third since 1990. Although there's been some debate regarding when a woman should start mammogram screenings, many professional medical societies, such as the American Cancer Society, suggest starting at age 40 and continuing with annual mammograms. However, the U.S. Preventive Services Task Force now recommends that women at an average risk begin at age 50 and follow up every two years.

Since the recommended screening guidelines are sometimes conflicting, you should discuss with your doctor to see what's best for you.