TECHNOLOGIST WORK SHEET
REASON FOR BREAST MRI EXAM
__ Presurgical evaluation (recently diagnosed breast cancer)
__ High risk screening
__ personal history of treated breast cancer
__ family history of breast cancer
__ history of high risk lesion (ADH, ALH, LCIS)
__ genetic predisposition (BRCA+)
__ Clinical concern (lump, breast pain, nipple discharge, skin changes)
__ Problem solving (mammographic or sonographic abnormality)
__ Response to chemotherapy
__ Short term follow up to prior MRI/MRI bx.
__ Rule out implant rupture
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