MRI screening for high-risk women

Breast MRI uses a strong magnet and radio waves, not X-rays, to create detailed pictures of the breasts. For screening, it is recommended mainly for women at high risk of breast cancer, because in these women it finds more cancers than mammography alone, particularly in younger women with dense breast tissue. The groups usually offered MRI screening include women who carry a harmful change in a gene such as BRCA, women with a very strong family history whose estimated lifetime risk is high, women who had radiation to the chest at a young age, for example for Hodgkin lymphoma, and women with certain rare inherited syndromes. MRI screening is typically done once a year, often alongside a yearly mammogram, and some centres space the two tests about six months apart. The scan involves lying face down on a padded table with the breasts in special openings, while a contrast dye is given through a vein in the arm. It takes around half an hour and is noisy but painless. MRI is very sensitive, which is its strength and also its drawback: it detects many harmless findings, leading to extra tests and sometimes biopsies. It is also more expensive and less widely available than mammography. MRI is not recommended for routine screening of women at average risk.

MRI is for high-risk women

Gene changes, strong family history and early chest radiation are the main reasons.

It adds to mammography

MRI and mammograms each find things the other can miss.

Expect some false alarms

Extra scans or biopsies after MRI are common and usually show nothing serious.

MRI is a powerful tool, but it has limits worth knowing.

It can still miss cancers

No test finds everything, so report any new symptom between scans.

Follow-up tests are common

Many women are recalled at least once over years of screening, especially after the first scan.

It is not suitable for everyone

Some pacemakers, metal implants, kidney problems or severe claustrophobia may prevent MRI.

What this page cannot tell you

It cannot tell you whether you qualify for MRI screening. That needs a formal risk assessment with a specialist.

Results are usually reported using the same scoring system as mammograms.

Normal or benign

You continue with your regular screening schedule.

Probably benign

A short-interval follow-up scan may be suggested to check the area is stable.

Suspicious

A second-look ultrasound or a biopsy is arranged. Most of these still turn out not to be cancer.

MRI is one part of looking after women at high risk, not the whole plan.

Regular clinical examination

Many high-risk women also have breast examinations by a specialist once or twice a year.

Genetic counselling

Counsellors help you and your relatives understand inherited risk and decide about testing.

Discussing risk reduction

Some women at very high risk consider medicines or surgery to lower risk, after careful discussion with specialists.