IRM mammaire : une voie pour la désescalade thérapeutique ?

The main current stake of breast cancerology is to improve treatment efficacy with less intense treatment. The concept of de-escalation of locoregional treatment fits in this context and aims at reducing the morbidity due to treatment and developing optimized and specific treatment strategies. The diagnostic performance of mammary MRI is now widely recognized with an excellent negative predictive value of over 95%. Screening studies of women with very high risk of breast cancer have also validated the excellent performance of MRI in the detection of both invasive and in situ carcinomas, with a higher sensitivity of MRI compared to the mammography and ultrasound couple. The question is how can MRI help with therapeutic or diagnostic de-escalation? In other words, can MRI contribute to optimizing therapeutic or diagnostic strategies? We will try to answer this question according to the clinical context.