Breast MRI: EUSOBI recommendations for women's information

Ritse M Mann, Corinne Balleyguier, Pascal A Baltzer, Ulrich Bick, Catherine Colin, Eleanor Cornford, Andrew Evans, Eva Fallenberg, Gabor Forrai, Michael H Fuchsjäger, Fiona J Gilbert, Thomas H Helbich, Sylvia H Heywang-Köbrunner, Julia Camps-Herrero, Christiane K Kuhl, Laura Martincich, Federica Pediconi, Pietro Panizza, Luis J Pina, Ruud M Pijnappel, Katja Pinker-Domenig, Per Skaane, Francesco Sardanelli, European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition, Ritse M Mann, Corinne Balleyguier, Pascal A Baltzer, Ulrich Bick, Catherine Colin, Eleanor Cornford, Andrew Evans, Eva Fallenberg, Gabor Forrai, Michael H Fuchsjäger, Fiona J Gilbert, Thomas H Helbich, Sylvia H Heywang-Köbrunner, Julia Camps-Herrero, Christiane K Kuhl, Laura Martincich, Federica Pediconi, Pietro Panizza, Luis J Pina, Ruud M Pijnappel, Katja Pinker-Domenig, Per Skaane, Francesco Sardanelli, European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition

Abstract

This paper summarizes information about breast MRI to be provided to women and referring physicians. After listing contraindications, procedure details are described, stressing the need for correct scheduling and not moving during the examination. The structured report including BI-RADS® categories and further actions after a breast MRI examination are discussed. Breast MRI is a very sensitive modality, significantly improving screening in high-risk women. It also has a role in clinical diagnosis, problem solving, and staging, impacting on patient management. However, it is not a perfect test, and occasionally breast cancers can be missed. Therefore, clinical and other imaging findings (from mammography/ultrasound) should also be considered. Conversely, MRI may detect lesions not visible on other imaging modalities turning out to be benign (false positives). These risks should be discussed with women before a breast MRI is requested/performed. Because breast MRI drawbacks depend upon the indication for the examination, basic information for the most important breast MRI indications is presented. Seventeen notes and five frequently asked questions formulated for use as direct communication to women are provided. The text was reviewed by Europa Donna-The European Breast Cancer Coalition to ensure that it can be easily understood by women undergoing MRI.

Key points: • Information on breast MRI concerns advantages/disadvantages and preparation to the examination • Claustrophobia, implantable devices, allergic predisposition, and renal function should be checked • Before menopause, scheduling on day 7-14 of the cycle is preferred • During the examination, it is highly important that the patient keeps still • Availability of prior examinations improves accuracy of breast MRI interpretation.

Keywords: Access to information; Breast; Breast cancer; Magnetic resonance imaging; Patient advocacy.

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