At the Hong Kong Sanatorium and Hospital in China, Gladys Lo, MD, and Polly Sy Cheung, MD, have been performing breast magnetic resonance imaging (MRI) examinations since November 2005 with a 3 Tesla MRI scanner. Breast MRI has been available for over a decade, but it has only recently become recognized as a vital complement to breast examination after mammography or ultrasound. Although MRI is not yet the routine procedure before breast cancer surgery, it may prove to be a useful adjunct in preoperative assessment in young breast cancer patients who often have denser breast tissue and whose mammography is thus much less accurate.

Changing Clinical Management

The research in Hong Kong supports this shift and helps illustrate how MRI examinations can help change clinical management. Reasons for the recent reassessment include the fact that breast MRI protocols are approaching standardization and the MRI breast-biopsy devices are now commercially available. Additionally, the high-resolution images can be obtained with both 1.5 Tesla and 3 Tesla scanners. With an average examination time of less than 30 minutes, MRI is also an efficient workflow solution.

Case Reports: Enhanced Breast Screening

Gladys Lo and Polly Sy Cheung present two cases where MRI examinations have enhanced breast screening. They highlight its use for patients with fibrocystic breast change, which shows multiple indeterminable shadows with ultrasound. They also investigated its use when discordant clinical, mammographic, and ultrasound findings appear, and how MRI can provide more information in these situations for breast cancer assessment.