Regular screening for breast cancer is important for all women, but women who are at a higher risk of developing breast cancer may need to follow a different set of recommendations for screening.
“There is some discussion in the medical community around mammograms about when screening should start and how often, but the American Cancer Society is very clear about breast MRI. It is the best tool to detect cancer for women who are high risk,” said Jessica Germino, MD, a specialist in breast imaging radiology at Samaritan Health Services and Corvallis Radiology.
Who Is High Risk?
According to the American Cancer Society (ACS), women who are high risk for breast cancer have at least one of the following:
- Received radiation to the chest between the ages of 10 and 30.
- A calculated risk of developing breast cancer (using risk assessment tools) greater than 20 to 25 percent.
- A genetic mutation known to increase the risk of breast cancer, like a BRCA gene mutation, or a first-degree relative with a BRCA genetic mutation but have not had genetic testing themselves.
- Certain genetic syndromes or a first-degree relative with a genetic syndrome that is known to increase the risk for breast cancer.
The ACS recommends that most of these women have both a mammogram and a breast MRI every year starting at age 30.
“As our understanding of genetics and breast cancer has progressed, we know there are multiple risk factors other than a BRCA mutation that can affect the risk of developing breast cancer,” said Dr. Germino. “If you or a family member has had genetic testing, talk to your doctor about the results and whether you are considered high risk for developing breast cancer. In those cases you would want to consider breast MRI for regular screening.”
How Breast MRI Works
An MRI machine uses magnets instead of radiation to take images of the soft tissue in the body. A breast MRI is an MRI with specialized coils to take an image of the breast tissue. During the procedure, the woman is given an IV with contrast dye in it. The radiologist watches the flow of dye through the blood during the MRI.
“If there’s a spot that takes up a lot of blood flow, that’s suspicious and that’s how we look for cancer,” said Dr. Germino.
For women who have concerns about the close quarters of an MRI, Dr. Germino recommended talking to your doctor. A mild sedative can improve the experience for patients with claustrophobia.
Additional Needs for Breast MRI
Dr. Germino reported that other reasons for needing a breast MRI include suspicious nipple discharge or to evaluate for additional cancers in women with a new breast cancer diagnosis.
“A breast MRI is very sensitive and can find things that may not show up on a mammogram or ultrasound,” said Dr. Germino. “It’s a great tool when we need to find out more information and see the breasts in detail.”