Breast Magnetic Resonance Imaging as a Problem‐Solving Modality?

Summary Mammography is the primary imaging modality for the early detection of breast cancer. Because of the low predictive value of mammography, a large majority of patient referred for biopsy have benign disease. The question is whether magnetic resonance imaging (MRI) is a diagnostic alternative to biopsy for women with inconclusive findings at mammography or mammographic (Breast Imaging Reporting And Data System (BIRADS) 3 lesions. In this article the breast MRI and indications will be described. An overview will be given of MRI as a problem‐solving modality in mammographic BIRADS 3 lesions and inconclusive mammographic findings with and without microcalcifications. The negative predictive value of breast MRI must be sufficiently high to definitively indicate a lack of need for biopsy and thus to be an effective addition to the work‐up of mammographic BIRADS 3 lesions or inconclusive findings on mammography. Therefore, breast MRI should only be used for cases with proven diagnostic value.