Guidelines for the Optimal Use of Breast Magnetic Resonance Imaging (MRI) for Screening of Breast Cancer in High Risk Women, Version 1. 2

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  • 乳がん発症ハイリスクグループに対する乳房MRIスクリーニングに関するガイドライン ver. 1. 2

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Breast magnetic resonance imaging (MRI) has gained acceptance for detecting breast cancer at an earlier stage than mammography, and is expected to make a significant contribution to breast cancer screening. However, as MRI is costlier, less available, and relatively more invasive than mammography, it is not a suitable method for screening of the general population. However,current evidence suggests that women with a high risk of developing breast cancer are not rare in the Japanese population, and that such women develop breast cancer at a younger age when mammography is not so accurate for detection of early breast cancer. The present guidelines are designed to optimize the use of MRI for breast cancer screening in high-risk women. The issues covered background indications, technical factors that affect image quality, and interpretation. The main content is based on the breast MRI guidelines issued by the American College of Radiology (ACR) and the European Society of Breast Imaging (EUSOBI). With regard to technical factors, intravenous contrast study is defined as the standard methodology. Also the importance of examination timing is emphasized. To avoid physiological enhancement of normal breast tissue, MRI should be performed within１０days after the end of menstruation. This is especially important for younger women at high risk. Non-contrast MRI including diffusion-weighted imaging is not recommended for this purpose because there is no definite evidence that has higher sensitivity to detect earlier breast cancer. In accordance with these guidelines, it is expected that optimal methodology for breast MRI will be adopted throughout Japan, thus reducing the breast cancer mortality rate among high-risk women.

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