Mammography with Magnetic Resonance

Magnetic Resonance (MR) offers numerous advantages as an additional tool for diagnosing breast cancer. It is of particular value for examining abnormalities that first have been detected by mammography. The technique also plays a significant role when it comes to visualizing breast implants or examining the breast tissue of young women.

In recent years, mammography with MR has increasingly become established as an additional imaging method in breast diagnostics. Approved by the U.S. Food and Drug Administration (FDA) in 1991, it plays an important role as a supplemental tool to mammography for diagnosing breast cancer. It is excellent in differentiating tissue and able to detect small abnormalities that can be missed with other examinations.

Potential for detecting multi-focal cancer

MR mammography is the most
sensitive method for diagnosing
breast cancer

There are numerous advantages to MRI as a diagnostic tool. The exam allows breast images to be taken from any orientation – in contrast to X-ray mammography which requires re-positioning of the breast and mammography system for each desired view. MRI is useful for investigating breast concerns that are first detected with mammography, physical examination or other imaging modalities and may show that the cancer is multi-focal. A 2004 study (Italian Trial for Breast MR in Multifocal/Multicentric Cancer) revealed that MR imaging is significantly better than mammography in detecting breast cancer in women who have already been diagnosed with the disease.

Appropriate for specific tissue conditions

MR plays a significant role when it comes to visualizing breast implants. Not only can it show if an implant is leaking or ruptured, but it can also image tissue that is compressed by an implant. X-ray used for mammography cannot penetrate silicone well enough to image the overlying or underlying breast tissue, and thus, abnormalities may be difficult to see. MRI, in contrast, is able to detect abnormalities despite the presence of an implant. Moreover, MRI may be an appropriate screening tool for young women who have a high risk of breast cancer. Young women tend to have dense breast tissue, for which MRI is more appropriate than X-ray mammography.

Because of its high accuracy in tissue differentiation, MRI is also becoming more and more important for staging breast cancer, which is integral to determining the most appropriate treatment. In particular, the pattern made with contrast enhancement is useful for lesion characterization. Physicians can also use MRI to detect cancer recurrences in patients who have already been treated with lumpectomy. Another advantage is the ability of MRI to differentiate between lesion and scar tissue. Moreover, it offers an extended Field of View (FoV) for lymph node staging and thereby allows a more accurate therapy planning.

Benefits of Breast MRI

• It offers a high sensitivity
• Breast MRI is effective for examining dense tissue and breast implants
• It is useful for tumor visualization
• Breast MRI can detect cancer recurrence
• Extended Field of View (FoV) for lymph node and tumor evaluation

Limitations and acceptance of MR breast imaging

Despite its advantages, MRI has a number of limitations as a diagnostic tool for breast cancer. First, it is non-specific, i.e. it is not always capable of differentiating between cancerous and non-cancerous tissue changes. This makes it difficult to rely solely on this method for drawing firm conclusions. Furthermore, unlike mammography, MRI cannot be used to image the calcifications that are often associated with early-stage breast cancers – an ability that mammography has. Finally, MRI is expensive and more time-consuming than mammography, and is not widely available for breast imaging.

Limitations of Breast MRI:

• It is non-specific
• Breast MRI cannot visualize calcifications
• It is expensive and not widely available
• Breast MRI is more time-consuming than mammography

Because of these limitations, acceptance of MRI as a method for detecting breast cancer is not yet widespread. It nevertheless has a particular value in breast diagnostics as it has proven to be the most accurate technique for identification of multifocal or multicentric lesions.