What are prerequisites for the performance and interpretation of magnetic resonance mammography (breast MRI)?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Breast MRI is a highly specialized diagnostic technique that complements clinical assessment and conventional imaging with mammography and ultrasound (US). It does not replace these techniques, except in certain unusual situations. In general, breast MRI should not be performed without conventional imaging performed first.

When breast MRI is performed for screening or evaluation of breast cancer, administration of an intravenous gadolinium-based contrast agent is a must. If the patient has a contraindication to gadolinium administration, breast MRI should not be performed for evaluation of breast cancer. Non-contrast MRI of the breast should only be performed for assessment of integrity of breast implants.

Breast MRI is best performed in a multidisciplinary setting with access to additional breast imaging, as well as close collaboration between the surgeon, radiologist, oncologist, and pathologist.

Radiologists experienced in MRI but without a strong knowledge of breast disease and diagnosis often have major difficulties with the interpretation of breast MRI studies. The radiologist interpreting breast MRI must (1) have a thorough understanding of breast pathology and diagnostic workup of breast diseases, (2) work closely with a breast surgeon and pathologist, (3) be experienced in the interpretation of mammograms and breast sonograms, and (4) be experienced in image-guided breast biopsy techniques.


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