CIBC Breast Assessment Centre
272923056705500Clinical Indications for Breast MRI Pre-op staging a) Lobular cancer: Biopsy diagnosis of Invasive lobular cancer, since commonly multi-focal/multi-centric, or bilateral and a frequent cause of positive surgical margins. b) Suspected multiple or bilateral cancer: Women with diagnosis of breast cancer and suspicion of multifocal or unclear disease extent due to dense breasts, may be undergo Breast MR as pre-op staging.Occult breast cancer: About 0.3% of breast cancers present with malignant axillary nodes, yet have normal breast clinical exams and mammograms. MR can locate the primary in the majority of cases, allowing breast conservation surgery. Women with metastatic disease and unknown primary may undergo mammogram and MRIPost-operative scar vs tumor recurrence: MR has high sensitivity and specificity to diagnose recurrence in scar. About 12-18 months or more after surgery, “mature scar”, which may simulate cancer morphologically, usually does not enhance. Recurrent tumor does enhance and typically has a malignant type enhancement curve.High-Risk Screening: . Women estimated to have >25% lifetime risk of breast cancer can undergo annual Bilateral mammogram and Breast MR as screening , once enrolled into OBSP high risk screening program. MR is not an appropriate exam for general screening, including patients treated for low grade cancersProblematic mammogram: In carefully selected cases, MR may be helpful with equivocal or suspicious mammographic findings. Detailed mammographic evaluation and ultrasound should be completed first.Important Note: MR and ultrasound may not detect some In situ carcinomas and other low-grade, benign or malignant lesions and is an adjunct to mammography. We currently consider In situ carcinomas to be primarily a mammographic diagnosis, although MR can help determine the extent of high grade DCIS in some cases.Please call if you would like to discuss other indications.Terry Minuk/ Kavita Dhamanaskar Juravinski Hospital and Cancer Centre, Hamilton Health Sciences(905) 521-2100 ext 43897 ................
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