Your Health: Breast MRI more widely used now that images, equipment are better

Magnetic resonance imaging (MRI) of the breast has been around since the late 1980s but has only become more widely utilized within the last 10 years. This is predominantly due to advances in equipment and image quality, and increased experience of interpreting radiologists. Breast MRI does not replace mammography and breast ultrasound. It plays a complimentary imaging role.
 

MRI may be used along with mammography for screening patients at high risk for breast cancer. High risk patients have a 20 percent or greater lifetime risk of developing breast cancer. These include patients with a known breast cancer gene mutation (e.g., BRCA) or a history of chest wall radiation therapy between the ages of 10 and 30. Women who have a mom, sister, daughter or father who have a known BRCA gene mutation also qualify for screening MRI.
 

Breast MRI can be utilized to evaluate the extent of disease in patients newly diagnosed with breast cancer. It is also helpful when looking for possible recurrence of breast cancer. Finally, MRI may be used to determine cancer response to chemotherapy prior to surgery, assess for silicone implant rupture, or search for underlying cancer in patients with biopsy-proven cancer in lymph nodes under the arms.
 

Breast MRI is performed with the patient lying face down on a padded platform on the MRI table. There are two holes within this platform for placement of the breasts. The holes contain coils that optimize the magnetic signals that generate MRI images. There is no radiation with MRI imaging. Gentle compression is applied for breast stabilization. It is crucial for the patient to remain completely still to obtain the best-quality images. The average time to complete the study is 30 minutes.
 

Breast MRI requires placement of an IV to administer contrast, a solution called gadolinium that becomes bright when exposed to the magnetic field. However, contrast is not used in patients who are being evaluated for implant rupture.
 

Earplugs can help to block the loud sound of the MRI magnet. If a patient is claustrophobic, she can be placed on the table feet first so that her head remains outside of the MRI tunnel during imaging.
 

Breast MRI is a very sensitive tool for imaging the breasts. It is best used in addition to mammography and breast ultrasound for the specific indications mentioned above. Those who have a history of contrast allergy or significant movement disorders, or others with implanted metallic devices, such as pacemakers, are not candidates for breast MRI.
 

Dr. Molly Hester is a breast radiologist with Central Baptist Hospital Breast Imaging Services.