Zakhireh Jennifer, Gomez Rachel, Esserman Laura
University of California, Department of Surgery, Division of Breast Surgical Oncology, San Francisco, CA 94115, USA.
Eur J Cancer. 2008 Dec;44(18):2742-52. doi: 10.1016/j.ejca.2008.09.008. Epub 2008 Nov 1.
Magnetic resonance imaging (MRI) has been increasingly utilized to screen and manage breast care. As the literature demonstrating its benefit expands, so do the potential clinical indications. However, routine review of the literature is merited to re-evaluate the appropriate and cost-effective use of MRI and guide clinicians in the areas of controversy.
A literature review was performed to evaluate the current evidence for the use of MRI.
Evidence supports MRI screening for genetic mutation carriers and for those with an equivalent lifetime risk (>50%). Regarding staging and management, MRI is indicated for monitoring tumour response to neoadjuvant therapy. MRI should also be considered for patients with invasive lobular carcinoma, mammographically occult breast cancer and Paget's disease.
Though MRI is limited by moderate specificity and high cost, it can be a valuable, sensitive and cost-effective tool with thoughtful and judicious patient selection.
磁共振成像（MRI）已越来越多地用于乳腺疾病的筛查和管理。随着证明其益处的文献不断增加，潜在的临床应用指征也在增多。然而，有必要定期回顾文献，以重新评估MRI的合理及成本效益使用情况，并在存在争议的领域为临床医生提供指导。
进行文献综述以评估目前使用MRI的证据。
有证据支持对基因突变携带者以及终生风险相当（>50%）的人群进行MRI筛查。在分期和管理方面，MRI适用于监测肿瘤对新辅助治疗的反应。对于浸润性小叶癌、乳腺钼靶隐匿性乳腺癌和佩吉特病患者，也应考虑使用MRI。
尽管MRI存在特异性中等和成本高的局限性，但通过审慎选择患者，它可以成为一种有价值、敏感且具有成本效益的工具。
