Unfortunately, there is no documented role for MRI of the breast AFTER someone has been diagnosed with breast cancer, even if the original cancer was not detected with mammography [“Hereditary breast cancer risk assessment in primary care,” January]. National Comprehensive Cancer Network guidelines do NOT include recommendations for MRI as a part of breast cancer surveillance.

It is quite a quandary for the patient, and many providers do order it, especially in women who have dense breasts. I specifically asked about the role of MRI after breast cancer diagnosis and treatment at a national conference for breast cancer, and I was told that there is no role.—ELIZABETH GARBER, MSN, FNP, NP-C, Goshen, Ind. (209-2)

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These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.