Breast MRI (Magnetic Resonance Imaging) is a highly sensitive but non-invasive imaging tool which can be used for the detection of breast cancer. It is an adjunct to traditional breast imaging modalities (mammography and ultrasound) and does not replace yearly mammography screening.
Breast MRI is a cross-sectional imaging technique which produces hundreds of images of the breast. In general, the images are taken both before and after the injection of intravenous contrast or dye. The contrast agent, called gadolinium, helps to highlight abnormal areas in the breast and is tolerated very well by most patients.
Breast MRI is very sensitive to all abnormalities in the breasts including malignant and benign processes which have increased blood flow.
Do you have questions about Breast MRI?
We have provided the answers to some of the most common and frequently asked questions.
There are several indications for Breast MRI including:
When you arrive at our office, you will be asked to fill out a questionnaire focused on your medical history related to breast disease. It is important to answer to the best of your ability and to bring any prior mammogram, ultrasound and MRI films.
When you are called for your exam, you will change into a hospital gown. Personal items such as your watch, wallet, credit cards, cell phones and any electronic devices, hearing aids, jewelry, metal hair clips etc. will need to be removed in order to obtain the highest quality exam. This is both to protect you, your belongings and to obtain the highest quality exam. It is advisable to leave valuables at home if possible.
An intravenous line will be started by a nurse or MRI technologist in order to administer the contrast material, gadolinium. This contrast agent is well tolerated by almost every patient. The actual exam time is approximately 30 minutes. During the exam you will lie on your stomach with each breast positioned in an indentation in the table. Ear plugs or music are supplied to muffle the loud sounds made by the scanning machine. Images are taken in rapid succession both before and after the injection of the intravenous contrast. It is very important to stay very still in order to get the best pictures, just like when you are taking a photograph. At the end of the exam, the intravenous catheter is removed. You can resume normal activities for the remainder of the day.
Once all of the images have been generated and processed through special computer programs, one of our specialized doctors, a board certified radiologist, will interpret the exam in conjunction with any prior imaging studies. You will receive the test results from your referring physician usually within a few days.
MRI is a safe exam for most patients. There is no radiation. The main contraindications to having any type of MRI include: heart pacemaker, cerebral aneurysm clip, medication pumps, implanted nerve stimulators, cochlear implants, or some breast tissue expanders.
People with the following medical devices can be safely imaged: surgical clips or sutures, artificial joints, surgical staples, most heart valve replacements, vena cava filters, disconnected medication pumps, brain shunts for hydrocephalus.
We do not routinely perform Breast MRI on pregnant or nursing women.
Breast MRI is very sensitive for the detection of breast cancer. It can show breast cancers that are not visible on mammogram or ultrasound, particularly in patients with dense breasts. In addition, it is better than mammogram or physical exam in defining the extent of disease when a diagnosis of breast cancer has been made. This information is very helpful for the breast surgeon for presurgical planning. Another advantage of MRI is that there is no radiation.
However, the sensitivity which makes MRI so successful at identifying cancers causes the identification of lesions which may be suggestive of cancer but are benign. These are called false-positives. Every exam has false-positives including mammography, ultrasound and physical exam, and these can cause anxiety for the patient.
Because of the experience of our dedicated Breast MRI doctors, false positive findings are kept to a low level similar to other imaging studies such as mammography and ultrasound. Importantly, if an indeterminate or suspicious area is identified on your exam, we are able to perform a biopsy with MRI guidance using the most advanced vacuum assisted biopsy machine.
At Thompson Health, we have a team of board certified radiologists with specialized training in MRI and breast imaging.
In addition, our Breast MRI practice is part of a broader full-service breast imaging practice offering digital mammography, state of the art ultrasound, stereotactic biopsy and vacuum assisted ultrasound guided capabilities.
If you are still menstruating, the best time of the month to have a Breast MRI exam is 7-14 days following the onset of your menstrual cycle in order to minimize hormonal effects on the breast tissue.
If you are post-menopausal and taking hormone replacement, we ask that you discontinue the hormones for six week prior to the exam.
Yes. Mammography remains the primary tool for breast cancer screening. Breast MRI does not replace mammography. Also, mammocgraphs are better than MRI at detecting calcifications, which may be one of the early signs of Breast Cancer.
Prior imaging studies help the doctor to give the most accurate interpretation of the MRI exam.
The Breast MRI exam is based on evaluating how blood flows into and out of different types of tissue in the breast. In order to do this, and intravenous contrast or dye called gadolinium is injected into a vein through an intravenous catheter. This contrast is well tolerated by almost all patients.
Images are taken in rapid succession both before and following the administration of contrast, producing hundreds of images. These images are then evaluated both visually and with special software programs that evaluate the blood flow. The contrast material is cleared from your body by your kidneys and excreted into the urine within 24 hours.
Gadolinium is an intravenous contrast or dye which is injected through an intravenous catheter during the exam. Gadolinium is very safe and well tolerated by nearly all patients. It is cleared from the blood by the kidneys and excreted into the urine within 24 hours. There will be no change in the color of your urine.
You should expect to be in the office for approximately 1 hour. In most cases, the actual scanning time is only 30 minutes.
Because hundreds of images are generated during one exam and the complexity of the computer programs utilized, the results are not immediately available. You will receive the results of the exam from your referring physician.
If there is an abnormality on MRI which is indeterminate or suspicious, and it is not present on mammogram or ultrasound, we can perform a needle biopsy using MRI guidance
A false-positive is a finding on an exam which is suggestive of cancer but which is actually benign. Such a finding can cause a great deal of stress and anxiety for the patient requiring an interventional procedure (needle biopsy) for clarification. By using state-of-the-art equipment to generate our studies which are interpreted by experienced doctors specialized in Breast MRI interpretation, false-positive findings are kept to a minimum. In addition, if indeterminate or suspicious abnormalities are found, we can perform a needle biopsy with MRI guidance. At Thompson Health, our expert team of traditional interventional breast imagers has enabled us to provide an extremely beneficial service to our patients and referring clinicians.
These are all terms which refer to an ultrasound recommended on the basis of a Breast MRI finding. The study is very specifically targeted to the exact location of the lesion based on the MRI exam for further evaluation.
We do not routinely perform Breast MRI in pregnant or nursing women because hormonal stimulation of the breast tissue interferes with the exam.