Gadolinium Retention and Breast MRI Screening: More Harm Than Good?

OBJECTIVE. The purpose of this article is to describe the risk-benefit balance of contrast-enhanced breast MRI (CE-BMRI) screening. CONCLUSION. CE-BMRI confers risk of effects associated with administration of gadolinium-based contrast agents (GBCAs), including nephrogenic systemic fibrosis and gadolinium retention. The risk-benefit balance of CE-BMRI screening is favorable for carriers of BRCA, TP53, or other deleterious mutations women who have undergone thoracic irradiation; and women at 20% or greater lifetime risk of breast cancer. The balance is uncertain, however, for women at intermediate to average risk. Women must always receive detailed information regarding possible GBCA-associated effects.