Breast MRI: Do You Have Breast Cancer or at High Risk

Learn about Breast MRIs for newly diagnosed women. We help you identify if you at High Risk and would benefit from annual screening MRIs.
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Questions for your Breast Surgeon:
1. Will you order a Breast MRI to look for other tumors?
2. Could a Breast MRI change our treatment plans?
3. Do I qualify for a “Screening Breast MRI?”
4. What are the disadvantages of a Breast MRI?
5. What are the benefits of Breast MRIs in newly diagnosed women?
By the time someone has had a biopsy showing cancer, they likely have already had a mammogram and possibly a breast ultrasound. Once diagnosed, a “Pre-operative Breast MRI” can sometimes show other cancers that have yet to be identified by mammography or a physician’s breast examination. A Breast MRI can also provide more information about the tumor’s size and involvement of other structures such as the muscle or skin.
When used before surgery (pre-operatively), Breast MRIs identify additional cancers in the same breast in about 16% of women and can find previously unknown cancers in the opposite breast in 3 to 5%. The findings from a pre-operative Breast MRI can change the surgical plans to treat your breast cancer. Breast MRIs are commonplace today and ordered by breast surgeons. Ask your surgeon if you would benefit from a Breast MRI before your surgery.
Why a “Screening Breast MRI” for women at “High Risk?”
Women identified to be a very high risk of developing breast cancer should consider an annual screening Breast MRI in addition to their annual mammogram, according to recommendations (here) by the American Cancer Society. Together, these two screening tests give doctors a better chance of finding breast cancer in high risk women when the cancer is smaller, easier to treat, and easiest to cure.
Consider a “Screening Breast MRI” if:
You are a BRCA1 or BRCA2 mutation carrier
You have a first-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation, even if you have yet to be tested yourself
Your lifetime risk of breast cancer has been scored at 20 to 25% or greater, based on one of several accepted risk assessment tools that look at family history and other factors such as a biopsy showing Atypical Ductal Hyperplasia (ADH), Atypical Lobular Hyperplasia (ALH), and Lobular Carcinoma In-Situ (LCIS)
You had radiation therapy to the chest for cancer (usually lymphoma) treatment between the ages of 10 and 30
What are the downsides of a Breast MRI?
If a breast MRI identifies a suspicious area in the breast, it may require a needle guided breast biopsy. Most of these additional biopsies prove to be benign, and can result in further imaging, anxiety, discomfort, and cost. In other words, Breast MRIs can lead to breast biopsies that might be considered unnecessary.
There is also evidence to suggest that women who undergo a pre-operative Breast MRI for cancer are more likely to choose to have a mastectomy than those who do not have a Breast MRI. Some leading physicians argue that Breast MRIs lead to unnecessary mastectomies without improvements in cancer outcomes. (see below reference) Ultimately, the choice of having a mastectomy is based on your unique breast cancer situation and your personal priorities.
Should I have a pre-operative Breast MRI?
Most importantly, speak with your breast surgeon. Ask specifically what the advantages and disadvantages are for your unique situation. Over the last decade, more and more pre-operative Breast MRIs are being performed. This trend will likely continue as breast surgeons seek more information before making surgical treatment decisions.
Those that benefit most from a pre-operative breast MRI are women younger than 50 years old, those with dense breasts, and BRCA mutation carriers. Ask your surgeon if your biopsy report also shows several high risk findings such as Atypical Ductal Hyperplasia (ADH), Atypical Lobular Hyperplasia (ALH), and Lobular Carcinoma In-Situ (LCIS). If your cancerous breast biopsy also showed these High Risk findings, then you benefit more from a pre-operative Breast MRI. You would likely also qualify for annual screening Breast MRIs in the years to come after your treatment if you are deemed at high risk and have a lumpectomy.
What is the take-home message?
In general, most breast surgeons feel pre-operative Breast MRIs are a good idea unless someone is elderly or extremely claustrophobic and would not tolerate the confined space of the MRI machine. If your breast surgeon never mentions a pre-operative Breast MRI as an option, you should inquire to become better informed.

[@nancynunez6837]

Had my Breast MRI 3 days ago, next week breast core breast biopsy stereotactic and a breast fine needle aspiration. Staying positive. I have a Family history, maternal side of the family.

[@YT-ml8gz]

Glad youre doing it in that order. That makes sense to me. My mammogram showed calcifications and i was told i needed a biopsy. So i had that last week and it came back as dcis. NOW, im told i need an MRI. And im doing the MRI tomorrow. But i feel like they shouldve done the mri first. I feel like the biopsy may have made a non invasive, contained cancer, invasive by poking at it? Doesnt that make sense? Ugh. Live and learn. Im praying its not invasive and ill be praying for you too AND all other people with cancer. God Bless.

[@zuuzsh.4373]

Hi…I hope u all r OK Nov.2022 ? 🤔😕✨🤲🏻✨

[@lindamastropietro4429]

Good luck to you

[@queen-servant-of-allah2822]

Excellent video thank u so much doc I did my MRI and CT scan today 🥰❤️

[@baasimariley9644]

I just love your videos I was recently diagnosed with stage 2b Hers triple positive and you eased my anxiety soo much. Thanks

[@BreastCancerSchoolforPatients]

So glad it was helpful. We try to teach the important concepts so you can make better treatment decisons with your physicians. Make sure you have watched our Her2-Positive video and read the text below the video and use the links to learn more. www.breastcancercourse.org/her2-positive-cancer-3-2/

[@ferminmonica2670]

Does , I was diagnosed once again . Now stage 1 before DCIS .. I’m still waiting for medical insurance which my doctor and a department in the clinic speeding the process bc my surgeon wants me to have reconstruction.. the cancer is HR2 estrogen and progesterone positive . I was and im nervous to wait a month

[@fatenhajj-ahmad2713]

New diagnosed with breast cancer after a biopsy. Did the MRI but showed nothing? Does that mean go with the surgery even though the MRI showed nothing or is there any other imaging or testing to do?

[@feaudaz5252]

How about if the MRI results come back clean? Do I still have to have the mastectomy? It only shows some cysts I found out results yesterday, Tuesday March 2, 2021. I am scheduled for March 9th. What would you suggest?

[@sharon268]

My twin had biopsy that came back Atypical hyperplasias and now I have a 5mm mass and a echo focus left breast it’s been a terrible experience the radiologist decision skip the diagnostic mammogram just do ultrasound that’s not what my physician wanted he still wanted the diagnostic mammogram so I schedule myself for the diagnostic mammogram and hospital imaging supervisor of scheduling calls me and scolds me like a child I told her your not involved in my care it’s not your business fast forward I just received an apology letter from the hospital and now she has been reprimanded for the insensitivity, I see the surgeon Monday to decide to get a breast MRI since I also have history of calcifications 2014 and now 8 years later the two new findings makes sense to get MRI and then biopsy

[@eazykkopalamusic401]

I want to go and have mri for my breast , im under 35 and they think mammographic test is not necessary, but I have dimpling with some soft lumps I don't want to be late. Should I go head dr

[@jeojackson534]

There is only one reason to do an MRI before a lumpectomy and that is if there is statistical evidence that this specific MRI captures more cancer cells than would have been taken out with just a lumpectomy. I cant take it for granted when a MRI manufacturer and a surgeon says its a good idea. Your video is very instructive Doc, but please give us numbers too.

[@BreastCancerSchoolforPatients]

Thank you for watching the videos and the feedback!

[@lindamastropietro4429]

What if I’m told I have a cyst but I don’t feel comfortable with that diagnosis I do have dense breast and a history of breast cancer in my family. What’s the next step?

[@audrinarivera566]

Hello, I'd like to know if anyone else out there has the CHEK2 Gene Mutation? It's very rare (1% gen. pop.).

[@DQ45]

Just got my genetic testing and chek2 positive.

[@nancybee250]

Just saw this question. My daughter was diagnosed with breast cancer before 30 so she had a genetic panel down and was positive for Chek2. Turns out I was positive and my son and my 91-year-old mother who’s never had any form of cancer thank goodness!

[@alicecrisostomofaelyab1148]

I am going to have a breast MRI I would like to ask if needed to remove my dental braces thanks

[@girlanonymous]

i think you should contact the place who's doing your MRI for the answer. They'd know best since they do MRI on patients daily.

[@maggieg5719]

Great question! What was the answer?

[@fahmchao5061]

If your identical twin sister has breast cancer at 32 but does not carrie the gene that cause breast cancer, does that still count as family history or puts me at even higher risk for having breast cancer in my life time?

[@lorib5398]

I was wondering if my twin sisters cystic breasts added to my risk.(Fraternal twin)

[@sharon268]

Farm Yes !!! It does My twin had biopsy that came back Atypical hyperplasias and now I have a 5mm mass and a echo focus left breast it’s been a terrible experience the radiologist decision skip the diagnostic mammogram just do ultrasound that’s not what my physician wanted he still wanted the diagnostic mammogram so I schedule myself for the diagnostic mammogram and hospital imaging supervisor of scheduling calls me and scolds me like a child I asked her your not involved in my care it’s not your business fast forward I just received an apology letter from the hospital and now she has been reprimanded I see the surgeon Monday decide to get a breast MRI since I also have history calcifications 2014

[@zuuzsh.4373]

When doctors say High risk,,,,does that means We have already Cancer 😮😬😓😥😨😰!?

[@detectivefiction3701]

No, why would it mean that? What it means is that a close relative of yours had breast cancer, so there might be a genetic component that affects you.

[@jessh2656]

No. Just means you have a higher risk for breast cancer

[@aandimeneseslongno1202]

Hi doc,I’m just watching this video about MRI.i had my first breast surgery October 25,2019.and I have the result Nov 4,2019,they diagnosed me an early BC stage 1 ER positive.i was shock and feeling depress.the next one is MRI Nov 25,2019 they found out both of my breast has tiny lump. And now I’m gonna undergo MRI Biopsy both breast again..I’m so scared to do it,like when I found out that I have another lump in my both breast soo scared to do the the biopsy Doc..ryt now I’m having anxiety and depress..

[@BreastCancerSchoolforPatients]

Hang in there. It is a long process. Make sure to visit our entire video based Breast Cancer School for Patients to learn more about your unique situation. www.breastcancercourse.org

[@JRMI3000]

My girlfriend was diagnosed with cancer pretty much at the same time as you, she's doing pretty good, don't be scare and keep a positive thoughts, that's the key and of course eat healthy and keep your body active, bless you and I know you're gonna be FINE.

[@Abc16895]

Alhamdolillah, i can treat the patient of chest cancer, lump/chest pain with 100℅ result in 25 to 30 days by the grace of Allah. Before spending so much troubles and money, consider it a necessity. You can whatsApp [phone]

[@user-lc5ts5fu2u]

Pease, don't get depressed or anxious, it's already there. It's ok to cry but pray to god so he will help to go through it. Hope

[@sOnlight67]

More money in the doctors pockets.🤔

[@nancybee250]

My daughter had a breast lump at age 28 and was told for 2 years it was just a cyst per mammogram results. An MRI could have saved her life.

[@christyb7455]

Very rude comment! These tests are saving more lives every day!

[@pradnya3820]

​@@nancybee250 how is she now?

[@nancybee250]

My daughter’s breast cancer was triple positive with a chek2 mutation. Because she had a delayed diagnosis. (due to medical incompetence/arrogance) she had six rounds of chemo double mastectomy, and 12 rounds of immunotherapy. It’s been two years since she is doing well but honestly i’m not comfortable with the current oncology perspective that just says we finished your treatment but we’re not gonna scan you to make sure your disease-free. I feel my daughter received good oncology care, but aftercare seems hit and miss.