Abbreviated Breast MRI

An abbreviated MRI (AB-MRI) for breast screening is a streamlined version of a full breast MRI designed to reduce scan time and improve accessibility while maintaining diagnostic accuracy.  They typically include fewer sequences than standard MRI, focusing on key images that are most informative for detecting breast cancer. This approach addresses some of the barriers to widespread use of full-protocol MRI, such as long scan times and high costs. AB-MRI typically includes a precontrast and a single postcontrast sequence, focusing on the early postcontrast phase when the kinetics of breast cancers differ most from benign tissue.

Abbreviated breast MRIs (AB-MRIs) are increasingly being adopted for breast cancer screening, but they are not yet widely available. AB-MRI protocols are designed to reduce scan time and costs while maintaining high diagnostic accuracy.

AB-MRI has been shown to have comparable diagnostic accuracy to full-protocol MRI, with significantly reduced acquisition and interpretation times. For example, a study demonstrated that an MRI acquisition time of 3 minutes and a reading time of less than 30 seconds for the complete AB-MRI protocol were sufficient to establish the absence of breast cancer with a negative predictive value of 99.8%.

The American College of Radiology (ACR) supports the use of AB-MRI for supplemental breast cancer screening, particularly in women with dense breasts, as it offers a higher cancer detection rate compared to mammography alone.

While AB-MRI has shown promise in clinical studies, demonstrating high diagnostic accuracy and efficiency, its adoption is still in the early stages. For example, a study in a community academic setting found that AB-MRI could be effectively used for women of various breast cancer risk profiles, but highlighted the need for further evaluation before widespread implementation.

Abbreviated breast MRIs (AB-MRIs) do not require special equipment beyond what is typically used for standard breast MRI. AB-MRI imaging requires intravenous contrast administration and lasts 10-15 minutes, compared to 30 to 45 minutes of a standard MRI. There is no radiation exposure or breast compression. It is not currently covered by insurance companies and requires an out-of-pocket expense, typically in the range of 500.00 USD.

AB-MRI Eligibility Criteria

  • Women who have had a negative mammogram (BI-RADS 1 or 2) within 11 months of the scheduled AB-MRI exam.

  • Women who are asymptomatic (e.g., no lumps, discharge, or pain).

  • Calculated lifetime risk less than 20%.

  • Women with a history of breast cancer who do not meet the criteria for supplemental screening with a conventional standard breast MRI and completed treatment more than two years ago.

Who does NOT qualify for AB-MRI

  • Women who have not had a negative or benign mammogram within 11 months of the scheduled AB-MRI examination.

  • Symptomatic women (e.g., palpable abnormalities, nipple discharge, and/or focal breast pain).

  • Women who are at a high risk for developing breast cancer (who should continue supplemental screening with standard breast MRI):

  • Calculated lifetime risk of developing breast cancer ≥ 20%

  • Disease-causing genetic mutation (e.g., BRCA, p53, PTEN, STK11)

  • First-degree relative with a known disease-causing mutation

  • History of prior chest radiation therapy before age 30

  • Hereditary or genetic syndrome associated with an increased risk for developing breast cancer (i.e., Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba Syndromes)

  • Personal history of breast cancer with dense breast tissue and/or diagnosed before the age of 50

  • AB-MRI should not replace standard MRI for follow up of a BI-RADS 3 (probably benign) assessment on the most recent prior MRI exam.