What is Breast MRI?
Breast MRI is a non-invasive way of looking at the breasts using a powerful magnetic field, radio frequency pulses, sophisticated computers and 3-D techniques to look deep into the tissue.
Breast MRI is most often used to determine the extent of a breast cancer, or look for additional cancer, in a patient who has already been diagnosed. MRI is also being used as an additional screening method for some women who are at high risk of developing the disease because of their family history or if they test positive for certain breast cancer genes.
MRI of the breast offers valuable information about many breast conditions that cannot be obtained by other imaging modalities, such as mammography or ultrasound. MRI has the highest sensitivity of breast imaging modalities.
Who Should Have Breast MRI?
Breast MRI is used for a specific population, due to its sensitivity. There are several indications for Breast MRI, including:
- Pre-operative planning or staging of newly diagnosed breast cancer
- High Risk Patients. This includes women who:
- Have a lifetime risk of breast cancer of 20% or greater, according to risk assessment tools that are based mainly on family history
- Have a known BRCA1, BRCA2, TP53, PTEN, STK11, CDH1, PALB2, CHEK2, ATM, NBN, BARD1 gene mutation based on having had genetic testing
- Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
- Had radiation therapy to the chest when they were between the ages of 10 and 30 years
- Monitoring the effect of chemotherapy
- Screening for women with previous breast cancer if mammographically occult malignancy/dense breasts
- Personal history of breast cancer, diagnosed before age 50
- Evaluation of equivocal findings on mammography or ultrasound
- Evaluation of breast implants for rupture
What should I expect when having a breast MRI?
The average Breast MRI appointment time can take up to 60 minutes while the actual scan time is only 20 minutes. You may eat, drink and take your usual medications prior to your MRI. However, limiting the amount of food is recommended just prior to imaging. The positioning of the exam requires lying on your abdomen.
Prior to the MRI scan, an IV will be placed in your arm. Most MRI exams require an IV injection of contrast (Gadolinium). The contrast is administered part way through the procedure. The contrast helps to clearly show breast tissue details.
You will lie face down on a padded table. Your breasts will hang freely into an opening in the table so they can be scanned without being compressed. The technologist will assist in making you comfortable to help eliminate motion during the exam. The table then slides into the magnet opening. When the images are being recorded, you will hear loud pulsating sounds. You will be given ear protection to help decrease the sound. About halfway through the exam the contrast will be injected into your IV and additional images are taken. The technologist will be checking on you during your scan. The only thing that is required of the patient is to hold still.
When the examination is completed, your IV will be removed. You should feel normal after the exam and be safe to drive home alone.
If you are claustrophobic or anxious about your MRI exam, you will need to get a prescription from your physician prior to your exam for medication that will make you comfortable during the study. However, you will need someone to drive you home afterwards.
How Do I Get the Results?
In some cases, additional imaging follow-up, such as ultrasound and/or possible biopsy, may be necessary after your MRI is read by the Radiologist. Because MRI is very sensitive, it may show certain findings that will not turn out to be cancer. These findings are referred to as false positives. We will contact you if any additional testing is needed. Otherwise, your primary care or referring physician will be contacted with the results, and will then share the results with you.
Do I Still Need a Mammogram if I Have a Breast MRI?
If MRI is used, it should be in addition to, not instead of, a screening mammogram. Although an MRI is more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect.
Is Breast MRI Safe?
No metal is allowed in the MRI room
- Be sure to tell the technologist if your occupation involves working with metal. You may be required to have an orbital x-ray prior to the MRI.
- All jewelry, hair pins and other metal must be removed
You cannot have an MRI if you have any of the following:
- A pacemaker or residual pacemaker leads
- A TENS unit or residual wires
- A defibrillator
- Any internal pump device
- An inner ear implant
- Brain aneurysm clips
- Any metal in your eyes
- You will be asked additional questions by the MRI technologists
Every insurance company has their own criteria for covering Breast MRI. Breast MRI requires pre-approval and an order from your referring physician. Please check with your insurance company to determine if you are eligible for an MRI.