Early detection | Use of the MRT ́s for breast cancer

Early detection

Magnetic resonance imaging is still not used extensively for the diagnosis of breast cancer in Germany. According to current medical guidelines (S3 guidelines), contrast medium MRI should not be used routinely for pre-therapeutic, i.e. also preventive, diagnostics. It is recommended as a supplementary diagnostic procedure, especially in cases of increased risk in the family.

This is particularly relevant for mutation carriers of the BRCA1 or BRCA2 gene. Female carriers of this gene become ill on average about 20 years earlier than women without familial hereditary risk. In addition, their risk of developing breast cancer at some point in their lives is significantly higher (50 – 80%) than that of the normal population.

For patients with a familial high risk, the S3 guideline therefore recommends MRI every 12 months from the age of 25 (or 5 years before the earliest age of onset of the disease in the family) until the age of 55. Another indication for an MRI is, among other things, an unclear finding after conventional diagnostics (mammography and sonography) or if a lymph node metastasis was detected but no primary focus was found. An MRI is also indicated if lobular carcinoma is suspected.

These occur significantly more frequently than other breast cancers in several breast quadrants (multi-centric) or even simultaneously in both breasts (bilateral) and are therefore considered more dangerous. In addition, an MRI examination is used for suspected breast cancer in women <40 years of age. An MRI for breast cancer diagnosis can also be useful for patients with breast implants, since silicone implants impair the view of glandular tissue behind them. Although magnetic resonance imaging may be useful in the above-mentioned cases, breast MRI is not a standard service of the statutory health insurance companies. For privately insured patients, the costs are usually covered for a given indication.

Aftercare

Once surgery, chemotherapy and radiation therapy are completed, the breast cancer patient begins the period of aftercare, which lasts about 5 years. During the first 3 years, a mammography is performed at least once a year. However, an MRI is usually not part of the standard aftercare for breast cancer. It is only indicated in the context of metastasis diagnosis or in case of clinical abnormalities.In addition, an MRI can be performed for local recurrence diagnosis for follow-up care if it is not possible to clearly differentiate between scar tissue and recurrence.