Current research shows an increase in invasive breast cancer in younger women, resulting in more significant benefits to earlier screening and, if necessary, additional screening. It is recommended that all individuals at average risk of breast cancer should begin screening mammography at age 40. 

Depending on your risk, medical history and current circumstances, your healthcare team may recommend additional screening tests, including If you are called back for further imaging after your mammogram. An additional imaging test may include a screening breast MRI.

What is a breast MRI?

A breast MRI (magnetic resonance imaging) can provide a more detailed image of the breast compared to mammograms or ultrasounds. It is especially beneficial for individuals with dense breast tissue or those at higher-than-average risk of breast cancer.  

Breast MRIs are considered accurate and safe. Studies have shown that in women with dense breasts: 

• MRI detects 12 to 16 more cancers per 1,000 patients compared to mammograms alone. 
• Screening ultrasound detects 3 to 4 more cancers per 1,000 patients compared to mammograms alone.

According to the American Cancer Society, a yearly mammogram and MRI are recommended for people at higher risk for developing breast cancer. 

“The full protocol MRI is recommended as a baseline screening MRI, for patients with some genetic mutations, and for staging of already diagnosed breast cancer,” adds radiologist Rebecca DeVries, DO. “It performs extra sequences which make the exam slightly more specific than the abbreviated MRI, though the sensitivity is similar.”

Discuss your medical history with your doctor, including any past allergic reactions to the contrast dye that will be used during the scan.

When would a breast MRI be recommended after a biopsy?

“A breast MRI could be recommended after a biopsy if the pathology showed a high-risk lesion,” says Dr. DeVries. “Some biopsy findings put a patient at higher risk of getting breast cancer in the future. If cancer is diagnosed on a biopsy, in some cases, an MRI may be recommended to make sure there isn't another cancer or more cancer in the breasts.”

Can a breast MRI replace mammography?

No. A breast MRI cannot replace a mammogram.

“All of the studies that have shown that breast screening saves lives were done with mammograms,” says Dr. DeVries. “There are some slow-growing cancers that are only found this way, so we recommend a yearly mammogram for women 40 or older who are at average risk, mammogram starting younger if higher risk, with an MRI as an additional screening tool. Some women that are very high risk (because of family history or a genetic mutation) should start MRIs at age 25, before they start yearly mammograms.”

What is an abbreviated MRI?

An abbreviated breast MRI, or “fast” breast MRI, is a shorter version of a full breast MRI. Taking about 15 minutes to complete, the abbreviated MRI scan takes about half the time of a full-breast MRI. 

Abbreviated MRIs can detect the same number of cancers as a full MRI and are slightly less specific, meaning they may find things that are not cancerous, which could lead to additional testing or biopsies.

Both abbreviated and full MRIs require a patient to:

• Have an IV to administer contrast dye. 
• Lay face down on the MRI table. 

Who should get an abbreviated breast MRI screening? 

Abbreviated breast MRIs should not be used as a baseline MRI exam unless it is a cash-pay exam or the patient cannot stay still for a full MRI. 

Most patients undergoing high-risk screening should get a full breast MRI as a baseline, with an abbreviated MRI used yearly for subsequent screenings. 

They are not recommended to be used for: 

• Staging a cancer diagnosis unless you cannot stay still for the full MRI. 
• Patients with a BRCA mutation, unless you cannot stay still for the full MRI. 

Partner with your doctor to determine if a breast MRI is your best option.

Assess Your Risk

The Nebraska Medicine Cancer Risk and Prevention Clinic offers:

• Personalized risk assessments.
• Risk-reduction strategies. 
• Recommendations for proactive screening.