What is a Breast MRI?
Using a strong magnetic field and radiowaves, MRI produces detailed 3 dimensional images of the breast that are very sensitive in detecting breast abnormalities. A woman lies face down with her breasts positioned through an opening on a table that moves into the scanner. Contrast dye (gadolinium) contrast is injected through an i.v. (intravenous catheter) and the whole procedure takes about 40 minutes. Please let us know at the time of scheduling your appointment if you are claustrophobic or have ferromagnetic metal implants in your body.
Just as automated whole breast ultrasound (ABUS) is used as a supplement to mammography in screening women with dense breast tissue, MRI is used as a supplement to mammography in screening women with high risk of breast cancer(link to high risk screening).
Other uses of MRI include:
- Determining the extent of cancer after a new diagnosis of breast cancer
- Further evaluating hard-to-assess abnormalities seen on mammography and ultrasound
- Following chemotherapytreatment in patients receiving neoadjuvant chemotherapy (chemotherapy given before surgery)
- Determining if silicone implants have ruptured (see below)
High risk MRI screening
The most common indication for MRI is screening women with high risk of breast cancer The American Cancer Society recommends high risk screening MRI in these groups of people:
- Women with a calculated lifetime risk greater than 20%
- More on risk assessment here(link)
- Gene mutations (BRCA 1 or 2, Li-Fraumeni, etc)
- This includes women who have been tested positive for these gene mutations as well as their untested first degree relatives.
- History of therapeutic radiation to the chest (for example, for lymphoma) prior to age 30 given by a radiation oncologist doctor.
Breast Implant Surveillance MRI
Breast MRI is the most sensitive and specific way to detect a silent rupture. The Food and Drug Administration (FDA) recommends that women with silicone implants check their implants with non-contrast MRI starting 3 years after initial implant surgery and every 2 years thereafter. If your implant has failed, your plastic surgeon can provide you with options and assist you in making a claim on the warranty. The major FDA-approved breast implant manufacturers (Mentor, Allergan) offer a 10-year warranty on their implants.