A. A screening MRI of the breasts is a yearly examination for women with no breast symptoms or complaints but a high lifetime risk of developing breast cancer. This exam must be performed in addition to annual mammography. According to the new American Cancer Society guidelines, indications for a patient to undergo screening breast MRI include: a known genetic mutation, a first-degree family member (i.e. mother or sister) with a known genetic mutation, a genetic syndrome associated with an increased risk of breast cancer (such as Li-Fraumeni syndrome, Cowden's syndrome or Bannayan-Riley-Ruvalcaba syndrome), a history of radiation therapy to the chest between the ages of 10 and 30 years, or a calculated lifetime risk of breast cancer of greater than 20 percent.

Women with a high lifetime risk of breast cancer include a person with breast cancer in a male relative, two or more first-degree relatives with premenopausal breast cancer, one family member with a history of two or more breast cancers, or one relative with both ovarian and breast cancer.

The indications for screening breast MRI do not include patients with dense breast tissue, patients with a previous personal history of breast cancer or patients with a personal history of an atypical breast biopsy.

Diagnostic breast MRI, on the other hand, is performed in certain specific clinical situations. This includes patients with a new diagnosis of breast cancer and patients with a suspected implant rupture. A physician may also obtain a breast MRI to further evaluate a breast symptom, such as nipple retraction, bloody or clear nipple discharge or a breast lump, if an initial mammogram and ultrasound are unremarkable.