MRI of the breast using scanners equipped with breast coils may be considered medically necessary for the following indications:

• For evaluation of breast cancer to determine if the breast cancer is multicentric (seen in several places);
• Known BRCA1 or BRCA2 mutation in patient or relative;
• A pattern of breast cancer history in multiple first-degree relatives, often occurring at a young age with bilaterality, consistent with a high probability of harboring BRCA mutations or other hereditary breast cancer;
• For detection of suspected occult breast primary tumor in patients with axillary nodal adenocarcinoma (e.g., negative mammography and physical exam); for presurgical planning in patients with locally advanced breast cancer before and after completion of neoadjuvant chemotherapy to permit tumor localization and characterization;
• To determine the presence of pectoralis major muscle/chest wall invasion in patients with posteriorly located tumor;
• To detect local tumor recurrence;
• To detect and stage invasive lobular carcinoma (ILC) for tailored therapy (e.g., breast conservation therapy);
• A mass distortion, etc in patient with history of breast cancer and the patient has had a prior mammogram and ultrasound
• Axillary mass with negative mammogram in a patient without history of breast cancer;
• To detect AND/OR confirm silicone breast implant leakage or rupture confirmed by the following diagnostic procedures:
  • Mammography to determine if a problem exists related to ruptured breast implant(s) (e.g., evaluate and isolate breast tissue from breast implant) or
  • Ultrasound of the breast to determine if ruptures or leads are present in breast implant(s)

Article provided by Radiology Associates of Ocala. The views expressed are not necessarily the views of Entercom.