MRI has been in the news a lot lately, and many women are asking us if they should have an MRI of their breasts. Data reported by German researchers at the 43rd Annual Meeting of the American Society of Clinical Oncology support MRI screening for breast cancer, and new American Cancer Society screening guidelines recommend MRI for women at high risk for breast cancer. Data from a recent paper published in the New England Journal of Medicine support MRI screening and suggest that MRI at a single site of breast cancer diagnosis can help detect a second breast cancer. However, not everyone has an avid love for breast MRI. The latest NCCN guidelines warn against relying too heavily on MRI exams, or using the results of laboratory tests as the sole determinant of treatment reference. Unfortunately, not all patients are candidates for breast MRI,” said Beryl McCormick, MD, PhD, of Medscape at Memorial Sloan-Kettering Cancer Center in New York. At Memorial Cancer Center we are seeing more and more patients with newly diagnosed breast cancer coming in with MRI images from outside the hospital, most of which are not useful to us, and some of which are not even readable by radiologists,” she continued. She continued, “We want to emphasize that MRI is only an adjunctive imaging test and should not be used as a substitute for mammography and ultrasonography” and suggested that “for the use of MRI, it is not routinely recommended based on the large population-based screening data available at this time. The idea that standardization of breast MRI exams has been an issue to be addressed is that MRI is a good device, but we just don’t have quality control in breast screening imaging. At the NCCN meeting, Dr. McCormick said, “MRI is useful in assessing the extent of biopsy for invasive lobular carcinoma, which is difficult to determine with mammography and ultrasound. MRI may be helpful in cases of suspected recurrence and in cases where mammography and palladium findings are inconclusive. In Germany, MRI is moving to new heights, high standards, and broader acceptance. While molybdenum palladium emphasizes calcification around ductal carcinoma in situ, MRI focuses on detecting areas of enhanced vascularization, a lesion process common in high-grade carcinomas. ”There is growing concern about overdiagnosis and unnecessary treatment of precancerous lesions in women, and MRI offers interesting potential.” In a prospective study, consecutive, more than 5,000 women were given screening or diagnostic evaluations. Patients underwent bilateral mammography, including at least 2-view plus point compression views, and high-resolution bilateral MRI imaging. Diagnostic sensitivity for ductal carcinoma in situ Sensitivity for screening for different grades of ductal carcinoma in situ. “Generally speaking diagnosing ductal carcinoma of the breast MRI is much more sensitive than mammography, especially for highly invasive carcinomas,” MRI doubles the diagnostic sensitivity of total ductal carcinoma, with half of all high-grade ductal carcinomas in situ being diagnosed by MRI alone,.