Converting evidence to practice: a guide for the clinical application of MRI for the screening and management of breast cancer.
BACKGROUND
Magnetic resonance imaging (MRI) has been increasingly utilized to screen and manage breast care. As the literature demonstrating its benefit expands, so do the potential clinical indications. However, routine review of the literature is merited to re-evaluate the appropriate and cost-effective use of MRI and guide clinicians in the areas of controversy.


METHODS
A literature review was performed to evaluate the current evidence for the use of MRI.


RESULTS
Evidence supports MRI screening for genetic mutation carriers and for those with an equivalent lifetime risk (>50%). Regarding staging and management, MRI is indicated for monitoring tumour response to neoadjuvant therapy. MRI should also be considered for patients with invasive lobular carcinoma, mammographically occult breast cancer and Paget's disease.


CONCLUSIONS
Though MRI is limited by moderate specificity and high cost, it can be a valuable, sensitive and cost-effective tool with thoughtful and judicious patient selection.
Zakhireh
Jennifer
J
University of California, Department of Surgery, Division of Breast Surgical Oncology, San Francisco, CA 94115, USA.
Gomez
Rachel
R
Esserman
Laura
L
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008403:Mass Screening / Q000379:methods*; D015414:Mastectomy, Subcutaneous; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging
D000970:Antineoplastic Agents