Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging, or MRI, is a breast-imaging technique that captures multiple cross-sectional pictures of your breast. Breast MRI consists of combining these images using a computer to generate detailed pictures, which are displayed on a monitor. It differs from x-rays in that MRI uses a large, powerful magnet to send magnetic waves through the body and then records the returning waves, making images appear on a computer screen. This is one of the newest high-tech tests and provides valuable images.
You may not be able to have an MRI of the breast if you have any metal equipment or clips in your body, such as a pacemaker, ear implant, metal clips in your eyes, implanted port devices, an intrauterine device (IUD), metal plates, pins, screws, or surgical staples. Some implanted devices are made of material that will not be affected by the MRI.
In recent years, staples and other objects have been made of non-ferromagnetic material and are safe with MRI. Be sure to tell your doctor if you have any metal objects in your body that may interfere with the MRI equipment and find out if those objects are safe or not.
An MRI is most effective in detecting smaller breast cancer tumors. MRIs are the most accurate diagnostic tool for the disease and can detect 79 percent to 98 percent of cancerous tumors. However, in some situations, the test is too sensitive and non-cancer changes are mistaken for cancer. This is a real problem when using MRI for screening.
Because of the high cost, it is not as widely used a screening tool, but for women at high risk for developing breast cancer it may be recommended. A study in high-risk women indicated that tumors found by MRI combined with mammography were significantly smaller and less likely to have spread to the lymph nodes. It is also known that in younger women who have denser breasts, traditional mammography has its limitations, and therefore combining mammography with MRIs can be more effective.
Your doctor may order an MRI of your breast to evaluate breast abnormalities seen on a mammogram or for women with dense breast tissue, implants, or scar tissue that interferes with regular breast imaging with mammography. An MRI may also be used to evaluate the progress of your breast cancer treatment as well as identifying cysts, enlarged ducts, hematomas, or leaking or ruptured breast implants.
In general, MRIs are not ordered for screening of benign and malignant tumors because of the high cost of the process and the fact the technology is so sensitive that it often mistakes non-cancer changes for cancer. You may advocate for an MRI of your breast by asking your doctor if it might be recommended for your situation. However if your doctor does not recommend it, be sure to understand her rationale for not indicating it for your situation.
What to Expect
Before your doctor schedules an MRI, she will likely do a physical exam and take a medical history, do a pregnancy test if you are premenopausal, assess any allergies you may have, and perhaps prescribe a mild sedative if you have anxiety or fear of enclosed places. Before your MRI, you may be asked to avoid using hairsprays, hair gel, lotions, and powders and cosmetics, because metallic substances used in some of these may interfere with the imaging.
The best time to schedule an MRI is between days seven and 14 of the menstrual cycle if you are premenopausal. If you take a mild sedative for this test, you should arrange for someone to drive you to and from the procedure.
Essential
Most MRI centers will have music available to help calm you during the procedure. The MRI machine makes loud noises during the procedure and your technician will alert you to this so that you have advance warning of the strange noises you may hear. Other relaxation techniques, such as meditation, centering practices of focusing on the breath, prayer, and yoga may be very helpful before your MRI.
Once you are at the MRI center, you will be asked to remove any metal objects, such as jewelry, watches, hearing aids, glasses, wigs, and non-permanent dentures. There is no pain associated with the procedure, so you will not need any anesthesia. During your MRI, you lie face-down on your stomach in a movable bed. Your breasts will hang into cushioned openings, during which the bed slides into a large, cylindrical-shaped magnet. You may be hooked up to monitors to check your pulse and heart rate during the procedure.
If your doctor has ordered an MRI with contrasting dye, then you will have a saline solution with contrast dye injected through an intravenous (IV) line into your hand or arm. The technician will leave the room during the procedure. The procedure without contrast dye takes about 30 to 40 minutes and up to one and a half hours for an MRI with contrast dye.
