Magnetic Resonance Imaging (MRI) of the Breast

Aetna covers breast MRI (with or without contrast) when a conventional mammogram and/or breast ultrasound within the past year exists and MRI would affect management—examples include prior chest radiation between ages 10–30, pre/post‑neoadjuvant chemotherapy staging for locally advanced cancer to assess extent and breast‑conserving eligibility, evaluation of symptomatic implant rupture, and suspected local recurrence after mastectomy with implant reconstruction. Screening for silent intracapsular rupture more often than every 2 years is not medically necessary, computer‑aided detection integral to MRI is not separately reimbursed, and MRI for dermatomyositis, quantitative breast density, or screening in APC/GALNT12 mutation carriers is considered experimental/investigational.

"Clinical indication documented in the medical record (e."

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