What is A breast MRI?

What is a Breast MRI?

Magnetic Resonance Imaging, commonly known as MRI, creates hundreds of imagines using magnetic fields and radio waves. A Breast MRI is a highly sensitive, non-invasive procedure that examines the breast.

How is a breast MRI different from a mammogram?

Traditionally, a mammogram is the standard for breast cancer detection. A breast MRI is not a substitute for your normal yearly mammogram. However, a breast MRI can be used to help detect and determine the stage of breast cancer. While mammograms use radiation with compression to produce images, breast MRIs do not require compression and there is no radiation exposure.

Many times, an MRI can detect small lesions in the breast that may be missed on a mammogram. However, MRI cannot always distinguish between cancer and benign breast diseases, such as fibro-adenomas, leading to false positive results. This is why mammograms remain the standard for breast cancer detection and diagnosis.

Who should have a breast MRI?

Even though mammography is the standard for breast cancer detection, some women with high risk factors might benefit from breast MRI. For example, women with dense breast tissue may benefit from a breast MRI. Other factors include:

• High-risk patients: The American Cancer Society guidelines recommend an annual MRI, as well as a mammogram for women who are at high risk of developing breast cancer. Heightened risk can be from a family history of breast cancer or other genetic factors, such as:
• BRCA1 or BRCA2 gene mutation
• First-degree relative with a BRCA1 or BRCA2 gene mutation
• Radiation treatment to the chest before age 30
• Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome (or a TP53 or PTEN gene mutation)
• ATM, CHEK2 or PALB2 gene mutation
• A greater than 20% lifetime risk of invasive breast cancer
• Breast cancer diagnosis: Women who have had cancer diagnosed in one breast should get a breast MRI to further evaluate both breasts.
• Newly diagnosed: MRI can help determine the extent and stage of breast cancer and assist in choosing the best treatment options.
• Monitoring therapy: Breast MRIs may also help monitor patients for response to treatment and to evaluate recurrent breast cancer.
• Implant status: This study is also recommended for women with breast implants to evaluate both the implant and the breast.

Breast MRI for implant integrity

MRIs are mostly used for cancer detection but, they can also be used for tracking breast implant integrity. Silicone gel breast implants have been determined safe by the FDA. However, because gel implants are thicker than saline, imaging is needed to determine the implant integrity. Currently, the FDA recommends an MRI 3 years after implantation and every 2 years to screen for implant integrity.

Healthcare providers can also use breast MRI to determine if an implant has ruptured. Typically, when saline implants rupture, a woman may notice a decrease in breast size, change in breast implant shape, hard lumps over the implant or chest area, an uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning or changes in sensation. However, if a silicone gel-filled implant ruptures, a woman may notice because of the denser gel material. This is called a “silent rupture.” MRI is the most effective method for detecting a silent rupture of silicone gel-filled breast implants.

How to prepare for a breast MRI

While MRI exams typically do not require special preparation, there are some things for you to remember prior to having your MRI:

• Bring a copy of the order for the procedure from your healthcare provider if given a copy, your insurance card and photo identification.
• No special preparation is needed for the majority of MRI exams. If you are having a brain, spine or joint MRI, you are able to eat a regular diet. For pelvic and abdominal exams, you should not eat or drink anything for 4 hours prior to your exam.
• Take your medications as usual prior to your exam.
• Wear comfortable, loose clothing made of cotton. Sometimes, depending on the material of your clothing, you may be asked to change into scrubs for your exam.
• You will be screened prior to entering the MRI room. You must remove ALL metallic objects including guns, hearing aids, dentures, partial plates, keys, cell phone, eyeglasses, hair pins, batteries, jewelry, body piercing, watch, safety pins, paperclips, money clip, credit cards, magnetic strip cards, coins, pens, pocketknife, nail clipper, tools and clothing with metal fasteners or metallic threads. This is for your safety and ours.
• If you have any implanted devices, notify your technologist at the time of screening. These include electric pacemaker, pump stimulators, diabetic pumps or other manmade devices. It is essential to bring device cards on any items that have been deemed as MRI compatible. You would be given this at the time of your implantation of the device. The MRI technologist will confirm that device is MRI safe prior to your appointment.
• The MRI system has a very strong magnetic field and it’s always on. Inappropriate entry to the MRI scanning room may result in a serious injury or death. DO NOT enter the MRI scan room without the permission of the MRI technologist. DO NOT enter the MRI scan room if you have any questions or concerns regarding the safety of your implant or device. 

What to expect during an MRI?

The MRI machine is a large cylindrical magnet with a large opening. When you enter the MRI room, you will be asked to lie down on a table and the machine will move you and the table into the correct position. Depending on the type of scan you are having, different devices called coils may be used to collect the MRI data. Typically, an MRI takes about 20-45 minutes, and you must be still during the exam in order to capture the best quality images possible. Motion can cause distortion of the images and will need to be repeated. The MRI machine is very loud, and you will hear tapping or thumping sounds during the exam. Earplugs and/or earphones will be provided for you. You are still able to communicate with your technologist through a microphone. You will also be given a squeeze ball to hold in case you need to stop the exam.

When your exam is completed, you may resume normal daily activities unless your healthcare provider instructs you otherwise. A board-certified radiologist will review the MRI images, and a report will be sent to your healthcare provider within a few days.

What if I am claustrophobic?

Patients who are claustrophobic may feel a “closed in” feeling during the MRI scan if your head is going first into the gantry. If this is a concern, please let us know prior to your appointment if you think you will require sedation. Your healthcare provider may prescribe something for the claustrophobia to be taken prior to your appointment.