Do All Women Need MRIs?

Do All Women Need MRIs?

December 14, 2021
Everett Bonner, MD
Everett Bonner, MD

Breast Surgery



After your diagnosis, you’re sitting around the table with your friends, having coffee, and one of your friends has breast cancer. And she says, “Did your surgeon order an MRI?” And you go, “No, he didn’t.” Well, there’s a reason for that.


Not all patients need MRIs. We have found there is a trend with a lot of breast surgeons that they will do an MRI on every single patient that has breast cancer. That is not clinically supported in the data right now. There are very particular circumstances that patients need an MRI. Lobular carcinoma, which is a specific type of breast cancer, patients who have an occult malignancy, it’s where they have lymph nodes that are positive but actually can’t find the disease, patients who are getting neoadjuvant chemotherapy, or, if your clinical exam you suspect there is more disease in that breast, and the mammogram or the ultrasound kind of underestimated the size and you want to make sure that patient has the ability to have breast conserving therapy, or you may need a mastectomy and you want to know the accurate size, because that helps out with clinical decision-making from a service standpoint, or if there were something that was mildly suspicious on the contralateral breast, which means the other breast that was not diagnosed with breast cancer, we may want to investigate that a little further.


So not every woman needs an MRI. And if your surgeon was not ordering that, there’s usually a reason for that because either you had a very early breast cancer or your standard imaging was very good and they have a very good picture of what’s going on in your breasts. So don’t be alarmed if your surgeon didn’t order that. There’s a very good clinical reason why.


Key Takeaways

1. Patients do not all need MRIs.

2. While some breast surgeons will do an MRI on every patient, they only need them with very particular circumstances like lobular carcinoma and occult malignancy.

3. If your surgeon didn’t order an MRI, you could either have very early breast cancer or your standard imaging was very good.