Ellis, Richard L. Optimal Timing of Breast MRI Examinations for Premenopausal Women Who Do Not Have a Normal Menstrual Cycle Am. J. Roentgenol. 2009 193: 1738-1740
Breast MRI is NOT to be used to screen asymptomatic patients for breast cancer except as noted in the criteria section. It is not sufficiently accurate to differentiate benign from malignant disease, especially clustered microcalcifications.
1.1.1 BRCA1 or BRCA2 gene mutation
1.1.2 Family history of breast or ovarian cancer in a first degree family member and Ashkenazi (Eastern European) Jewish background
1.1.3.1 Reference: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Breast Cancer Screening and Diagnosis, Version 1.2019 – May 17, 2019
1.1.4 First degree Male relative with breast cancer
1.1.5 One first degree relative relative with either 2 breast cancers or both breast and ovarian cancer
1.1.6 Two first degree relatives with breast or ovarian cancer
1.1.7 Relative who is a confirmed carrier of the BRCA1 or BRCA2 gene mutation
1.1.8 LI-FRAUMENI SYNDROME – including first degree relatives
1.1.9 COWDEN SYNDROME – including first degree relatives
1.1.10 BANNAYAN-RILEY-RUVALCABA SYNDROME – including first degree relatives
1.2 Radiation therapy to the chest between the ages of 10-30
1.3.1 Nipple retraction
1.3.2 Unilateral, spontaneous nipple discharge which is bloody or clear and from only 1 or 2 ducts.
1.3.3 Evaluate for a primary occult breast cancer in patients with adenocarcinoma suggestive of breast cancer discovered elsewhere in the body.
2.1 Newly diagnosed breast cancer to aid in treatment planning
2.2 To evaluate for residual cancer in the recently postoperative patient with positive margins still desiring breast conservation
2.3.1.1 Partridge S, Gibbs J, Yin L, et al. Accuracy of MR imaging for revealing residual breast cancer in patients who have undergone neoadjuvant chemotherapy. AJR Am J Roentgenol. 2002;179:1193–1199.
2.3.1.2 Chagpar AB, Middleton LP, Sahin AA, et al. Accuracy of physical examination, ultrasonography, and mammography in predicting residual pathologic tumor size in patientstreated with neoadjuvant chemotherapy. Ann Surg. 2006;243:257–264