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Breast MRI scan
Definition
A breast MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the breast and surrounding tissue. It does not use radiation (x-rays).
A breast MRI may be done in combination with mammography or ultrasound. However, it is not a replacement for mammography.
See also:
Alternative Names
MRI - breast; Magnetic resonance imaging - breast
How the Test is Performed
You will lie on your stomach with your breasts hanging down into cushioned openings. The narrow table slides into the MRI scanner, which is shaped like a tunnel.
You may be asked to wear a hospital gown or clothing without metal fasteners (such as sweatpants and a t-shirt). Certain types of metal can cause blurry images.
Some exams require a special dye (contrast). The dye is usually given before the test through a vein (IV) in your hand or forearm. The dye helps the radiologist see certain areas more clearly.
During the MRI, the person who operates the machine will watch you from another room. The test most often lasts 30 - 60 minutes, but it may take longer.
How to Prepare for the Test
You may be asked not to eat or drink anything for 4 - 6 hours before the scan.
Tell your doctor if you are afraid of close spaces (have claustrophobia). You may be given a medicine to help you feel sleepy and less anxious, or your doctor may suggest an "open" MRI, in which the machine is not as close to the body.
Before the test, tell your health care provider if you have:
- Brain aneurysm clips
- Certain types of artificial heart valves
- Heart defibrillator or pacemaker
- Inner ear (cochlear) implants
- Kidney disease or dialysis (you may not be able to receive contrast)
- Recently placed artificial joints
- Certain types of vascular stents
- Worked with sheet metal in the past (you may need tests to check for metal pieces in your eyes)
Because the MRI contains strong magnets, metal objects are not allowed into the room with the MRI scanner:
- Pens, pocketknives, and eyeglasses may fly across the room.
- Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
- Pins, hairpins, metal zippers, and similar metallic items can distort the images.
- Removable dental work should be taken out just before the scan.
How the Test Will Feel
An MRI exam causes no pain. If you have difficulty lying still or are very nervous, you may receive medicine to relax you. Too much movement can blur MRI images and cause errors.
The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises when turned on. You can wear ear plugs to help reduce the noise.
An intercom in the room allows you to speak to someone at any time. Some MRIs have televisions and special headphones that you can use to pass the time.
There is no recovery time, unless you were given a medicine to relax. After an MRI scan, you can resume your normal diet, activity, and medications.
Why the Test is Performed
MRI provides detailed pictures of the breast. It also provides clear pictures of parts of the breast that are difficult to see clearly on ultrasound or mammogram.
Breast MRI may also be performed to:
- Check for more cancer in the same breast or the other breast after breast cancer has been diagnosed
- Distinguish between scar tissue and tumors in the breast
- Evaluate a breast lump (usually after biopsy)
- Evaluate an abnormal result on a mammogram or breast ultrasound
- Evaluate for possible rupture of breast implants
- Find any cancer that remains after surgery or chemotherapy
- Guide a biopsy (rare)
- Screen for cancer in women at very high risk for breast cancer (such as those with a strong family history)
- Screen for cancer in women with very dense breast tissue
An MRI of the breast can also show:
- Blood flow through the breast area
- Blood vessels in the breast area
What Abnormal Results Mean
Abnormal results may be due to:
- Breast cancer
- Cysts
- Leaking or ruptured breast implants
Consult your health care provider with any questions and concerns.
Risks
MRI contains no radiation. To date, no side effects from the magnetic fields and radio waves have been reported.
The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance rarely occur. However, gadolinium can be harmful to patients with kidney problems who require dialysis. If you have kidney problems, please tell your health care provider before the test.
The strong magnetic fields created during an MRI can make heart pacemakers and other implants not work as well. It can also cause a piece of metal inside your body to move or shift.
Considerations
Breast MRI is more sensitive than mammogram, especially when it is performed using contrast dye. However, breast MRI may not always be able to distinguish breast cancer from noncancerous breast growths. This can lead to a false positive result.
MRI also cannot pick up tiny pieces of calcium (microcalcifications), which mammogram can detect.
A biopsy is needed to confirm the results of a breast MRI.
References
Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75-89.
Lehman CD, DeMartini W, Anderson BO, Edge SB. Indications for breast MRI in the patient with newly diagnosed breast cancer. JNCCN. 2009;7:193-201.
James JJ, Robin A, Wilson M, Evans AJ. The breast. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 52.
Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomized controlled trial. Lancet. 2010 Feb 13;375(9714):563-71.
Turnbull LW, Brown SR, Olivier C, et al.; COMICE Trial Group. Multicentre randomised controlled trial examining the cost-effectiveness of contrast-enhanced high field magnetic resonance imaging in women with primary breast cancer scheduled for wide local excision (COMICE). Health Technol Assess. 2010 Jan;14(1):1-182.
Bevers TB, Anderson BO, Bonaccio E, et al.; National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis. J Natl Compr Canc Netw. 2009 Nov;7(10):1060-96. Review. Erratum in: J Natl Compr Canc Netw. 2010 Feb;8(2):xxxvii.
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
