MRI indicated at diagnosis:
in a woman with newly diagnosed breast cancer, at risk of multifocality, to assess the need for mastectomy or lumpectomy;
Guidelines for Breast MRI Eligibility
April 1, 2008 2 minutes read
Guidelines for Breast MRI Eligibility
MRI indicated at diagnosis:
- in a woman with newly diagnosed breast cancer, at risk of multifocality, to assess the need for mastectomy or lumpectomy;
- in a woman with an occult breast cancer diagnosed with only axillary adenopathy. The breast cancer is occult on mammography, ultrasound, or physical exam;
- in a woman receiving neoadjuvant chemotherapy, to assess both at diagnosis, and at the post chemotherapy, preoperative period for disease extent;
- in a woman with a posteriorly placed tumor to determine pectoralis muscle involvement;
- in a woman who has an MRI-detected lesion who has no evidence of it on mammogram, ultrasound, or physical exam. An MRI in follow up is allowed at six months following benign pathology on a biopsy of that site to ensure that the site was assessed or at a shorter interval if the pathologic findings are considered discordant with the MRI appearance of the lesion;
- in a woman six months after a previous MRI with BI-RADS Category 3 findings;
- for the presence of pathologic nipple discharge when mammography, ultrasound, and ductography either cannot be performed or the results are equivocal or negative.
MRI eligible every two years:
- in a woman who has undergone a mastectomy and a reconstruction with an implant;
- in a woman with radiographically dense breasts and a breast cancer history;
- in a woman who is premenopausal with dense breasts and a personal history of cellular atypia, lobular carcimoma in situ, breast cancer, or a single first-degree relative with premenopausal breast cancer;
MRI eligible every year:
- in a woman who has the confirmed presence of a BRCA1 or BRCA2 gene mutation or other syndrome that has a high incidence of breast cancer such as Li-Fraumaeni, Cowden, or Bannayan-Riley-Ruvalcaba. Also included are patients with a greater than 20% lifetime risk of breast cancer as defined by published, validated models that are mainly defined by family history;
- in a woman who has a high likelihood of having a BRCA mutation because of: three or more first degree relatives on the same side of the family, regardless of age at diagnosis with breast cancer; fewer than three relatives who were diagnosed at less than 45 years old; a family member detected with a BRCA mutation; one or more family members with ovarian cancer and one or more members with breast cancer, both on the same side of the family; there are multiple breast cancers in one family member; male breast cancer in a family member; the woman is a member of an ethnic group at high risk for breast cancer (Ashkenazi Jewish descent) and one family member with breast or ovarian cancer; or the presence of Li-Fraumaeni, Cowden, or Bannayan-Riley-Ruvalcaba in a first-degree relative;
- in a woman with a history of chest radiation between the ages of 10 and 30.
Source: Rutland (VT) Regional Medical Center, adopted from the Vermont Blue Cross Blue Shield Guidelines.
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