Breast Density

Breast density, which is a representation in mammography of the amount of breast parenchyma present in the breast, can be assessed on MRI on both T2- and T1-weighted images. Breasts are characterized using BI-RADS (Breast Imaging Reporting and Data System) criteria:
1: almost entirely fatty;
2: scattered fibroglandular densities;
3: heterogeneously dense; and
4: extremely dense as with mammography

Unlike mammography, dense breasts generally do not pose a significant problem on MRI as contrast is used and thin slices are obtained, thus overlapping parenchyma is not a hindrance. There are, however, a small set of patients who exhibit very early rapid enhancement of the parenchyma, which can obscure small enhancing suspicious foci. In these cases, it may be helpful to communicate the lowered sensitivity of MRI to the referring physician.

(A) MLO Mammography image and (B) Contrast-enhanced MRI breast image.


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