BlueCross BlueShield of Tennessee Medical Policy Manual

Magnetic Resonance Imaging (MRI) of the Breast


Magnetic resonance imaging (MRI) is a non-invasive test using a multiplanar imaging method based on an interaction between radiofrequency (RF) electromagnetic fields and certain nuclei in the body (usually hydrogen nuclei) after the body has been placed in a strong magnetic field. The magnetic resonance (MR) scanners and intravenous magnetic resonance contrast agents are used to create detailed pictures of areas inside the body.

These images are intended to differentiate between normal and diseased tissue. MRI of the breast has been investigated as a screening tool in specific higher risk subgroups of individuals. Specialized breast coils are used during the imaging of the breast. MRI of the breast may be performed bilaterally or unilaterally. MRI of the breast is not meant to replace mammography, percutaneous biopsy or ultrasound in the screening for breast cancer in the general population.





High Risk Individuals are defined as individuals with a 20% or greater lifetime risk of developing breast cancer. 

The modified Gail model risk assessment is accessible at

BI-RADS™ Categories:


American College of Obstetricians and Gynecologists. (2015). Committee Opinion. Management of women with dense breasts diagnosed by mammography. Retrieved July 18, 2018 from

American College of Radiology. (2017). ACR appropriateness criteria. Breast cancer screening. Retrieved July 18, 2018 from

eviCore healthcare. (2020, July). Breast imaging policy. Retrieved January 6, 2021 from (45 articles and/or guidelines reviewed)

eviCore healthcare. (2020, October). Oncology imaging policy. Breast cancer. Retrieved January 6, 2021 from (9 articles and/or guidelines reviewed)

National Comprehensive Cancer Network. (2020, November). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 2.2021. Retrieved January 7, 2021 from the National Comprehensive Cancer Network.

National Comprehensive Cancer Network. (2020, September). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Breast Cancer, Version 6.2020. Retrieved January 7, 2021 from the National Comprehensive Cancer Network.




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