Imaging in breast cancer: magnetic resonance imaging

Abstract

Over the past 5 years there has been a marked increase in the use of magnetic resonance imaging (MRI) of the breast. Multiple research studies have confirmed improved cancer detection, diagnosis, and evaluation of response to therapy with breast MRI compared with mammography and ultrasound. As this exciting new technology advances, focused work in optimal scan protocols, appropriate clinical applications, and image interpretation are needed. Both the potential benefits and harms need to be evaluated to guide optimal use of this imaging modality in select patient populations.

Figure 1

MRI results in a woman 52 years old with recent diagnosis of right breast cancer. Left mammogram negative. Pre-contrast (a) and post-contrast (b) enhanced sagittal MR images reveal an 8 mm enhancing mass at 12 o'clock in the left breast (arrowed). Core needle biopsy confirmed infiltrating ductal carcinoma. Final pathology from lumpectomy demonstrated an 8 mm infiltrating ductal carcinoma; sentinel lymph node negative.

Figure 2

MRI results in a 46 year old woman at high risk for breast cancer. Sagittal pre-contrast T₂ (a), post-contrast T₁ (b) and magnified view (c) of 8 × 3 × 3 linear focus of enhancement in left breast at six o'clock (arrowed). The lesion was negative on mammography and screening ultrasound. Pathology proved infiltrating ductal carcinoma.