Breast MRI as a screening tool: the appropriate role

Magnetic resonance imaging (MRI) can detect breast cancer that is occult on mammography or ultrasound. However, although the high sensitivity of this imaging modality is desirable, its lower specificity, higher cost, variable technique and interpretation among institutions, exclusion criteria, and unproven effect on survival rate make it a less desirable screening test for the general population. Several studies have shown that using more than one imaging tool, such as MRI and mammography, increases cancer yield in high-risk patients, such as those with inherited BRCA1 and BRCA2 mutations. Recent studies show improved specificity of MRI, likely related to advances in technique and the development of interpretive guidelines.