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Breast MRI: Clinical Indications, Recommendations, and Future Applications in Breast Cancer Diagnosis

  • BREAST CANCER (ME GATTI-MAYS, SECTION EDITOR)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This article aims to provide an updated overview of the indications for diagnostic breast magnetic resonance imaging (MRI), discusses the available and novel imaging exams proposed for breast cancer detection, and discusses considerations when performing breast MRI in the clinical setting.

Recent Findings

Breast MRI is superior in identifying lesions in women with a very high risk of breast cancer or average risk with dense breasts. Moreover, the application of breast MRI has benefits in numerous other clinical cases as well; e.g., the assessment of the extent of disease, evaluation of response to neoadjuvant therapy (NAT), evaluation of lymph nodes and primary occult tumor, evaluation of lesions suspicious of Paget’s disease, and suspicious discharge and breast implants.

Summary

Breast cancer is the most frequently detected tumor among women around the globe and is often diagnosed as a result of abnormal findings on mammography. Although effective multimodal therapies significantly decline mortality rates, breast cancer remains one of the leading causes of cancer death. A proactive approach to identifying suspicious breast lesions at early stages can enhance the efficacy of anti-cancer treatments, improve patient recovery, and significantly improve long-term survival. However, the currently applied mammography to detect breast cancer has its limitations. High false-positive and false-negative rates are observed in women with dense breasts. Since approximately half of the screening population comprises women with dense breasts, mammography is often incorrectly used. The application of breast MRI should significantly impact the correct cases of breast abnormality detection in women. Radiomics provides valuable data obtained from breast MRI, further improving breast cancer diagnosis. Introducing these constantly evolving algorithms in clinical practice will lead to the right breast detection tool, optimized surveillance program, and individualized breast cancer treatment.

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Acknowledgements

Authors thank Dr. David Gray for assistance in writing in English.

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Authors and Affiliations

  1. Location Academic Medical Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Demi Wekking

  2. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Demi Wekking

  3. Radiology Department, AOU Cagliari, Policlinico Di Monserrato (CA), Monserrato, Italy

    Michele Porcu & Luca Saba

  4. Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Pushpamali De Silva

  5. Broad Institute of MIT and Harvard, Cambridge, MA, USA

    Pushpamali De Silva

  6. Medical Oncology Department, AOU Cagliari, Policlinico Di Monserrato (CA), Monserrato, Italy

    Mario Scartozzi & Cinzia Solinas

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  1. Demi Wekking
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  4. Luca Saba
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Contributions

The authors confirm their contribution to the paper: Demi Wekking drafted the manuscript. Michele Porcu wrote a part of the manuscript and prepared the MRI figure. Cinzia Solinas supervised the entire process. All authors reviewed the manuscript, gave intellectual input to the finalization of the manuscript, and approved the final version of the manuscript for submission.

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Correspondence to Demi Wekking or Cinzia Solinas.

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Wekking, D., Porcu, M., De Silva, P. et al. Breast MRI: Clinical Indications, Recommendations, and Future Applications in Breast Cancer Diagnosis. Curr Oncol Rep 25, 257–267 (2023). https://doi.org/10.1007/s11912-023-01372-x

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