Breast MRI

MRI of the breast is not a replacement for mammography or ultrasound imaging, but rather is a supplemental tool for detecting and staging breast cancer and other breast abnormalities. ??MRI is used to:
·                evaluate abnormalities detected by mammography.
·                identify early breast cancer not detected through other means, especially in women with dense breast tissue and those at high risk for the disease.
·                determine the integrity of breast implants.
·                distinguish between scar tissue and recurrent tumors.
·                assess multiple tumor locations.
·                check the progress of chemotherapy.
·                look for multiple tumors prior to breast conservation surgery.
·                determine whether cancer detected by mammography or ultrasound has spread further in the breast or into the chest wall.
·                determine how much cancer has spread beyond the surgical site after a breast biopsy or lumpectomy.
·                provide additional information on a diseased breast to make treatment decisions.
 
Because the risks to a fetus are unknown, pregnant women should not have an MRI exam unless the potential benefit from the MRI is determined to outweigh the potential risks.

What to expect with your procedure

You may be given a hospital gown to wear during the exam, or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Metal and electronic objects can interfere with the MRI's magnetic field and are not allowed in the exam room. These items include:

· Jewelry, watches, credit cards, and hearing aids, all of which can be damaged

· Pins, hairpins, metal zippers, and similar metallic items, which can distort MRI images

· Removable dental work

· Pens, pocketknives, and eyeglasses

 

If your physician is using a contrast material during your MRI exam, a nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm.

You will be positioned face down on the moveable bed with your breasts hanging into the cushioned openings. The bed will then be moved into the magnet of the MRI unit.

The technologist will leave the room while the MRI examination is performed. You will be asked to lie still while the machine acquires the images. Imaging is done in sequences, each lasting between one and fifteen minutes. In between sequences, you will be able to relax. You will know when images are being recorded because you will hear tapping or thumping sounds when the coils that create the magnetic field are turned on.

After an initial series of scans, the contrast material is injected into the intravenous line. Additional series of images are taken following the injection.

When your exam is completed, you will wait a short time on the table while the images are evaluated to ensure no additional images are needed. Your intravenous line will be removed.

The imaging session lasts between 30 minutes and one hour and the total exam will take approximately an hour and a half.

MRI of the breast is a pain-free procedure. Your breasts may feel slightly warm, but this is normal and harmless. If contrast is used, there may be discomfort at the injection site and you may have a cool sensation at the site during the injection. Some patients can find it uncomfortable to remain still during MR imaging.

When it is inserted, the intravenous needle may cause you some discomfort; once it is removed, you may experience some bruising. There is also a very small chance of irritation or infection. When the contrast agent is injected, it is normal to feel coolness throughout your body.

During your exam, you will be able to talk to the technologist, who will observe you from an adjacent room throughout the exam. You may request earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. MRI scanners are air-conditioned and well lit.

Following your MRI, no recovery period will be necessary. You may resume your usual activities and normal diet immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local pain. Very rarely, patients are allergic to the contrast medium and experience hives and itchy eyes.

It is recommended that nursing mothers not breastfeed for 36 to 48 hours after an MRI with a contrast material.

Preparing for your procedure

You will be given intravenous contrast with your MRI, so you may be asked if you have an allergy of any kind such as hay fever, hives, allergic asthma, or allergy to food or drugs. However, the contrast material used for an MRI exam, called gadolinium, does not contain iodine and is less likely to cause an allergic reaction. You may not be able to receive gadolinium if you have kidney disease and your doctor will order a simple blood test to asses this before your MRI.

Prior to your exam, you may continue to take your usual medications, unless you are told otherwise.

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. Tell the technologist if you have medical or electronic devices in your body, such as:

· Artificial heart valves

· Implanted drug infusion ports

· Implanted electronic devices

· Artificial limbs or metallic joint prostheses

· Implanted nerve stimulators

· Metal pins, screws, plates or surgical staples

 

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question, an x-ray may be taken to detect the presence of any metal objects. Sheet metal workers and others who might have metal objects such as shrapnel in their bodies may also require an x-ray prior to an MRI. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem.

People with the following implants cannot be scanned and should not enter the MRI area:

· Cardiac pacemakers

· Defibrillators

· A cochlear (ear) implant