WHAT IS A BREAST MRI?
Magnetic resonance imaging (MRI) is a noninvasive test that obtains multiple cross-sectional pictures of your breast. It uses a magnetic field, radio-frequency pulses (not x-rays), and a computer to produce detailed pictures that can then be evaluated on a computer monitor.
MRI of the breast does not replace mammography, but is a supplemental test for detecting and staging breast cancer and other breast abnormalities. Breast MRI is best used in addition to a mammogram. Although MRI a very sensitive test, breast MRI can still miss some breast cancers that a mammogram will detect.
The MRI unit is a large tube-shaped machine. It houses a powerful magnet and electronics. The computer workstation that processes the imaging information is located in a separate room just outside the MRI scanner.
REASONS FOR BREAST MRI
1. Strong family history of breast cancer or ovarian cancer.
2. High risk of breast cancer. If you are unsure whether you are considered high-risk, ask your doctor to help you determine your personal risk
3. Diagnosis of breast cancer; Your doctor wishes to determine the extent of the cancer and to evaluate your other breast.
4. Suspected leak or rupture of a silicone breast implant.
5. History of chest radiation for Hodgkin's disease before age 30.
6. Evaluation for an unknown primary breast cancer in a patient with metastatic adenocarcinoma.
HOW SHOULD I PREPARE FOR THE TEST?
If you are premenopausal, we prefer to schedule your MRI the week after your menstrual cycle/period ends. Let our staff know where you are in your cycle so that best possible appointment for your breast MRI can be arranged.
Follow any special instructions that you receive when you make the appointment for the imaging test. Tell the MRI staff if you have a cardiac pacemaker or other electronic device implanted in your body. You should always inform us if there is any possibility that you are pregnant. Pregnant women should not have this exam unless the potential benefit from the MRI is assumed to outweigh the potential risks
Jewelry, clothing with metal zippers, and other metal containing items should be left at home or removed prior to the MRI study. Metal and electronic objects are not allowed in the exam room. These objects could be pulled into the magnet and are a safety hazard. In addition, these objects can interfere with the magnetic field and with your test.
The intravenous contrast material used for the MRI test is called gadolinium. It does not contain iodine; therefore, it is less likely to cause side effects or an allergic reaction. Please inform the MRI staff if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease, may prevent you from being given contrast material for an MRI.
If you have claustrophobia (fear of enclosed spaces), you may want to ask your referring doctor to write a prescription for a sedative for you to take before the MRI test. If you do take a sedative, for your safety and for the safety of others, you must have a driver to take you home after the test.
HOW IS THE PROCEDURE PERFORMED?
You will be asked to undress from the waist up and to wear a gown during the procedure.
All patients having a breast MRI will have an intravenous line (a tiny hollow tube placed in a vein) that will be used for the administration of contrast material during the test. An MRI technologist will insert an intravenous line (IV) into a vein in your hand or arm.
For the breast MRI test, you will lie face down on your stomach with your breasts hanging freely into openings in a device called a breast coil. It is important to remain very still throughout the exam. Make sure that you are comfortable and can relax rather than trying to actively hold still tensing your muscles. Inform the technologist if something is uncomfortable, since it will increase the likelihood that you will feel the need to move during the exam. Any movement can limit the ability to get a quality test.
You will be placed into the magnet of the MRI machine and the technologist will leave the room while your test is performed. During the test, the technologist monitors you from another room. You will be able to talk to the technologist through a special microphone.
MRI exams generally include multiple runs (sequences), some of which may last several minutes. MRI contrast material will be injected into your IV line after an initial series of scans. Afterwards, additional series of images will be taken. When the examination is completed, you may be asked to
wait until the technologist checks the images in case additional images are needed. Your intravenous line will then be removed.
HOW LONG WILL THE TEST TAKE?
The MRI examination usually takes 50-60 minutes.
WHAT WILL I EXPERIENCE DURING AND AFTER THE MRI?
Most MRI exams are painless. Some patients, however, find it uncomfortable to remain still during the MRI test. After being placed on the MRI table, you will be alone in the room during the test. However, the technologist will be able to see, hear and speak with you at all times.
You will be given earplugs to wear to reduce the noise of the MRI machine, which produces loud thumping and humming noises during imaging.
When the IV contrast material is injected, you may feel a cool flushing sensation for a minute or two. When the IV needle is inserted it may cause you some discomfort. After it is removed, you may have some bruising at the skin site. Also, there is a very small chance of irritation of your skin at the IV tube insertion site.
A few patients experience side effects from the MRI contrast material, including nausea and local pain. Rarely, patients are allergic to the contrast material and experience hives, itchy eyes or other reactions. If you experience allergic symptoms, a physician will be available for immediate assistance. Nephrogenic systemic fibrosis is currently a rare complication of MRI contrast and is thought to be caused by the injection of high doses of MRI contrast material in patients with very poor kidney function. If you have poor kidney function or are unsure, please inform the MRI staff.
WHO INTERPRETS THE TEST?
A radiologist, a physician trained to interpret radiology breast tests, will evaluate the images and send a signed report to your referring physician.
HOW DO I GET MY RESULTS?
The radiologist will send a signed report to your referring physician. You should obtain your results from that referring doctor.
LIMITATIONS OF BREAST MRI
Breast MRI is not a screening test for the general population.
Breast MRI is an evolving technology and should not replace standard screening and diagnostic tests (clinical and self exams, mammogram, or biopsy). At this time, breast MRI does not detect certain types of very small calcifications, which on a mammogram can be an early indication of cancer.
High-quality images for your test can be obtained only if you are able to remain perfectly still during the test. If you are anxious, confused or in severe pain, you may find it difficult to lie still during the test. Please inform your technologist at the time of your exam and ask questions if needed.
MRI of the breast may not always be able to tell the difference between a cancer and a non-cancerous (benign) breast area. However, if a suspicious area is detected on your breast MRI, you will need to have it further evaluated. Such areas often turn out to benign after further study with mammogram, ultrasound or even biopsy.
Another thing to consider is the cost of a breast MRI test – it is expensive, $1,000 or more. In some cases, insurance companies will not cover the expense of the test, so you may have to pay out-of-pocket for the exam. Before having your breast MRI, please check with your insurance company to see whether you will be covered.