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For most women, mammograms are the only screening technology they will ever need for monitoring their breast health. Women with suspicious masses or fibrous breast tissue can expect to have an ultrasound, and possibly a MRI.
Breast MRI is very sensitive and is useful for assessing invasive carcinomas. It is also used to assess high-risk patients who have more than a 20 percent chance of developing breast cancer in their lifetimes based on genetics (BRCA1 and BRCA2) and strong family history of breast cancer. Since it is such a sensitive technology, benign findings may be detected on MRI. This can cause the patient unnecessary anxiety.
If a MRI detects a suspicious lesion that isn’t recognizable and doesn’t correspond to anything visible on the mammogram, then a second-look ultrasound is recommended. If visible, the lesion may be biopsied under ultrasound guidance; if not, it may need to be biopsied under MRI guidance.