Breast MRI Test and Procedure
Overview
Magnetic resonance imaging (MRI) is a detailed imaging test that uses strong magnets, radio waves, and a computer to create clear pictures of the inside of the breast. Doctors often use breast MRI to find breast cancer and can gather information that other tests may not show.
It helps check the size and location of cancer, especially after a biopsy confirms its presence. Doctors sometimes use breast MRI with mammograms to look for cancer in people who have a higher risk, such as those with a family history or certain genetic factors. This method helps doctors spot problems early or rule out cancer when there are concerns.ย
Key Features of Breast MRI:
- Uses magnets and radio waves, not x-rays.
- Gives more detailed images than many other tests.
- Can be used for both screening and diagnosis.
Reasons for Use
Doctors use breast MRI to check for possible problems in the breast, especially when other tests like mammography or ultrasound do not give enough information. They often recommend it for people at higher risk of breast cancer, such as those with a strong family history or certain gene mutations like BRCA1 or BRCA2.
If a person has very dense breast tissue, regular mammograms may miss some cancers, so a breast MRI can help find tumors that are harder to see. After diagnosing a person with breast cancer, doctors use breast MRI to look for other areas of cancer in either breast.
This helps guide treatment and planning. Doctors also use breast MRI to check for possible leaks or ruptures in breast implants, offering another way to assess implant safety when questions arise. Other reasons for having a breast MRI include:
- Family members with a history of breast or ovarian cancer.
- Unusual breast changes, such as atypical hyperplasia or lobular carcinoma in situ.
- A history of radiation to the chest, especially between the ages of 10 and 30.
- A personal risk of breast cancer calculated at 20% or higher over a lifetime, based on family history and other risk factors.
Breast MRI does not replace other imaging tests. Instead, it works alongside mammography and sometimes ultrasound to provide a more complete view. For example, women at very high risk of breast cancer may be screened every six months, alternating between mammograms and breast MRI.
Uses of Breast MRI at a Glance
| Reason | Description |
|---|---|
| Screening high-risk individuals | Used when lifetime risk of breast cancer is 20% or higher. |
| Checking for more cancer | Examines both breasts for possible additional cancer after a diagnosis. |
| Dense breast tissue | Helps spot cancers not seen with mammograms. |
| Implant evaluation | Checks for implant leaks or ruptures. |
| Family history or gene mutations | Recommended for strong family history or BRCA1/BRCA2 mutations. |
| Previous chest radiation | Important for those who received radiation to the chest at a young age. |
Possible Concerns
While breast MRI is considered safe and does not use radiation, some risks exist. Sometimes, MRI shows areas that look suspicious but turn out not to be cancer, leading to extra tests and stress. These are called false positives. This can result in more imaging, such as an ultrasound, or even a biopsy that may not be necessary.
Doctors use a special dye called gadolinium to make the MRI images clearer, but it can cause allergic reactions in rare cases. People with kidney problems should be especially careful, as gadolinium could cause serious health problems for them.
| Potential Risk | Description |
|---|---|
| False positive result | Further tests with no actual cancer found |
| Gadolinium reaction | Possible allergy or complications in kidney conditions |
How You Prepare
Before a breast MRI, certain steps can help make the test smoother and safer. Below is a straightforward guide to help with preparation:
Timing of the MRI: For those who have not reached menopause, the imaging center usually recommends scheduling the MRI between days 5 and 15 of the menstrual cycle. The first day of bleeding marks day one. Patients should inform the facility about their cycle so the appointment is planned during the ideal window.
Allergies: Patients need to let their health team know about any allergies. Most MRI scans use a contrast dye called gadolinium for clearer images. Sharing information about allergies in advance helps prevent possible reactions.
Kidney Health: Anyone with kidney problems should inform the health care provider. The contrast dye might cause issues for individuals with certain kidney conditions. Reporting this before the appointment is important.
Pregnancy and Nursing: If someone is pregnant, they should mention this to the healthcare team, as MRIs with contrast are usually avoided during pregnancy. For nursing parents, it may be suggested to stop breastfeeding for 12 to 24 hours after the MRI. They can pump and store milk before the scan and discard milk pumped right after the procedure.
Avoiding Metal Objects: Wearing metal items is not allowed during an MRI. Patients should leave jewelry, watches, hairpins, eyeglasses, and any other metal items at home or remove them before entering the imaging area.
Implanted Medical Device: Those with implanted devices, such as pacemakers, defibrillators, artificial joints, or drug ports, must tell the medical team about them in advance.
Quick Reference Table
| Step | What to Do |
|---|---|
| MRI timing | Schedule during days 5โ15 of menstrual cycle |
| Allergies | Tell staff about any allergies |
| Kidney issues | Tell staff if kidneys are not healthy |
| Pregnancy | Tell staff if pregnant |
| Nursing | Consider pausing breastfeeding post-scan |
| Metal items | Remove all metal before exam |
| Implanted devices | Tell staff about any implants |
Preparing in these ways can help the MRI process go more smoothly and help make sure the results are clear and accurate.
What to Expect During the Test
When patients arrive for a breast MRI exam, staff usually ask them to change into a gown and remove any jewelry or metal objects. Those who feel nervous in tight spaces should let a nurse or technician know early; sometimes a mild relaxing medicine can be provided.
Before the test begins, staff may give a special dye (contrast agent) through an IV in the arm. This helps create clearer and more detailed images of breast tissue and blood vessels. The MRI machine is shaped like a big tube with a wide opening. Patients lie face down on a table with spaces for their breasts.
These spaces have special coils that help collect signals needed for the imaging. The table moves into the opening of the scanner so the exam can begin.
- The MRI signal uses strong magnets and radio waves, but patients do not feel anything during the scan.
- Loud tapping or knocking sounds are common, so earplugs or headphones are often provided.
- The technologist watches and communicates with the patient through an intercom at all times.
- Patients should keep still and breathe normally for the best images.
The breast MRI test usually takes between 30 and 60 minutes. After the test, patients can normally return to their regular routine.
Findings
After a radiologist examines the breast MRI images, a member of the healthcare team discusses the results with the patient. These findings help with:
- Breast tissue evaluation
- Accurate diagnosis
- Planning treatment
