Authors' objectives:

This review aims to assess the available evidence on magnetic resonance imaging (MRI) for the detection of breast abnormalities.

Authors' recommendations: With regard to MRI for the detection of breast abnormalities, the ICSI Technology Assessment Committee finds: MRI as a screening test for the low-risk general population has not been studied and should not be performed at this time. Mammography and ultrasound should be used for the initial evaluation of breast symptoms. Reported sensitivities of MRI for detecting invasive breast cancer ranged from 93%-100% and specificities ranged from 37%-96% (Conclusion Grade II). Sensitivities of MRI for detecting ductal carcinoma in situ (DCIS) ranged from 45%-100%. Based on 2 studies, breast MRI has been shown to accurately estimate residual disease in 97%-100% of patients after induction chemotherapy prior to surgery (Conclusion Grade III). MRI screening of high-risk patients (previous personal or strong family history of breast cancer or carriers of a breast cancer susceptibility gene) is currently being studied in several multicenter studies. Reported sensitivities of MRI for evaluation of silicone breast implant rupture ranged from 78%-87% and specificities ranged from 76%-91%. MRI is helpful in ruling out invasive cancer in many problem-solving situations. Negative predictive values have ranged from 96%-100%. However, MRI should not be used to avoid further evaluation of a suspicious lesion seen mammographically or sonographically. In the absence of contraindications, MRI is a safe procedure. Patients should be aware of possible false-positive and false-negative findings which have ranged from 4%-63% and 0%-55%, respectively, depending on the indication. Facilities offering MRI for breast cancer evaluation must also have a breast center where further assessment with diagnostic equipment (including biopsy) can be done.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.icsi.org/knowledge/detail.asp?catID=107&itemID=1454

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical Systems Improvement

Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675

Contact Name: icsi.info@icsi.org

Contact Email: icsi.info@icsi.org

Copyright: Institute for Clinical Systems Improvement (ICSI)