One alternative to

mammography Mammography (also called mastography; DICOM modality: MG) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cance ...

, breast MRI or contrast-enhanced

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...

(MRI), has shown substantial progress in the detection of

breast cancer Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...

Uses

Some of the uses of MRI of the breasts are: screening for malignancy in women with greater than 20% lifetime risk of breast cancer (especially those with high risk genes such as

BRCA1 Breast cancer type 1 susceptibility protein is a protein that in humans is encoded by the ''BRCA1'' () gene. Orthologs are common in other vertebrate species, whereas invertebrate genomes may encode a more distantly related gene. ''BRCA1'' is a ...

and

BRCA2 ''BRCA2'' and BRCA2 () are human genes and their protein products, respectively. The official symbol (BRCA2, italic for the gene, nonitalic for the protein) and the official name (originally breast cancer 2; currently BRCA2, DNA repair associate ...

), evaluate breast implants for rupture, screening the opposite side breast for malignancy in women with known one sided breast malignancy, extent of disease and the presence of multifocality and multicentricity in patients with invasive carcinoma and ductal carcinoma in situ (DCIS), and evaluate response to neoadjuvant chemotherapy. MRI of the breasts has the highest sensitivity to detect breast cancer when compared with other imaging modalities such as

breast ultrasound Breast ultrasound is a medical imaging technique that uses medical ultrasonography to perform imaging of the breast. It can be performed for either diagnostic or screening purposes and can be used with or without a mammogram. In particular, bre ...

. In the screening for breast cancer for high-risk women, sensitivity of MRI ranges from 83 to 94% while specificity (the confidence that a lesion is cancerous and not a

false positive A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test resu ...

) ranges from 75.2% to 100%.

Nephrogenic systemic fibrosis

The systemic disease

nephrogenic systemic fibrosis Nephrogenic systemic fibrosis is a rare syndrome that involves fibrosis of the skin, joints, eyes, and internal organs. NSF is caused by exposure to gadolinium in gadolinium-based MRI contrast agents (GBCAs) in patients with impaired kidney funct ...

(NSF), caused by exposure to gadolinium in

MRI contrast agents Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. Physics of magnetic resonance imaging#MRI scanner, MRI scanners use strong ...

, resembles

scleromyxedema Papular mucinosis (also known as scleromyxedema, "generalized lichen myxedematosus" and "sclerodermoid lichen myxedematosus") is a rare skin disease. Localized and disseminated cases are called papular mucinosis or lichen myxedematosus while gen ...

and to some extent

scleroderma Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs. The disease can be either localized to the skin or involve other organs, as well. Symptoms may include areas ...

. It may occur months after contrast has been injected. Patients with poorer kidney function are more at risk for NSF, with dialysis patients being more at risk than patients with

chronic kidney disease Chronic kidney disease (CKD) is a type of long-term kidney disease, defined by the sustained presence of abnormal kidney function and/or abnormal kidney structure. To meet criteria for CKD, the abnormalities must be present for at least three mo ...

. After several years of controversy during which up to 100 Danish patients have been gadolinium poisoned (and some died) after use of the

contrast agent A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radiop ...

Omniscan, the Norwegian medical company Nycomed admitted that they were aware of some dangers of using gadolinium-based agents for their product. At present, NSF has been linked to the use of four gadolinium-containing MRI contrast agents.

References

{{Medical imaging Magnetic resonance imaging Breast imaging