More than 275,000 women in the United States will receive the diagnosis of breast cancer this year, and over 40,000 women will die of the disease. Breast cancer mortality is second only to that of lung cancer and for women ages 40-55 it is the leading cause of death. Randomized trials have shown that the use of screening mammography in the general population reduces mortality associated with breast cancer by at least 24 percent. Yet many challenges remain to improve detection and guide appropriate therapy. Mammography may miss 15-20% of cancers, particularly in patients with dense fibroglandular tissue which may obscure an underlying tumor. Recent research has demonstrated that MRI can detect some small breast lesions sometimes missed by mammography.

Today, breast MRI has emerged as an extremely helpful imaging tool in evaluating mammogram abnormalities and identifying early breast cancer, especially in women at high risk. Similar to a regular MRI (magnetic resonance imaging) in which a magnetic field is used to produce accurate and detailed images from areas inside the body, a breast MRI produces hundreds of images of the breast from side-to-side, top-to-bottom, and front-to-back. 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 as well as other breast abnormalities.

Who qualifies for a breast MRI?

MRI can help detect breast cancer in women with breast implants, inverted nipples, and younger women with dense breast tissue—all of which are difficult to image using traditional mammography. Because MR imaging does not involve radiation, the procedure can be used to screen women younger than the age of 40. Also, by employing MRI in regular practice the number of screenings per year increase for women at high risk for breast cancer, ultimately, detecting breast cancer even earlier. Breast MRI is covered by insurance. The American Cancer Society (ACS) recommends that women with cancer, women at high risk for breast cancer, and women with breast implants should have an annual MRI scan in addition to mammography.

Under what conditions should breast MRI be performed?

• MRI is used to evaluate breast lumps found during a physical examination, ultrasound, or mammography.
• Breast MR imaging is vital in determining the integrity of breast implants. It assists in evaluating the breast implants for leaks, ruptures or areas of suspicious. MRI scanning can detect leakage from a silicone-filled breast implant, since it easily distinguishes silicone gel from surrounding normal breast and chest wall tissues.
• MRI is excellent for looking at scar tissue. MRI is able to distinguish between scar tissue and recurrent tumors. Therefore, breast MRI can evaluate a significant change in the lumpectomy site. It can determine how much cancer has spread beyond the surgical site after a breast biopsy or lumpectomy. MRI can also determine whether cancer detected by mammography or ultrasound has spread further in the breast or into the chest wall.
• Breast MRI is utilized to look at what stage of breast cancer is present, evaluate breast tissue changes during treatment and check the progress of chemotherapy. MRI assists by providing additional information on a diseased breast to make the best treatment decisions.

Benefits

MRI is a non-invasive imaging technique that does not require exposure to radiation.

MRI has been shown to detect small breast lesions that are sometimes missed by mammography.

MRI provides more clear and detailed images of the soft-tissue structures of the body than other imaging methods. The detail makes MRI an invaluable tool in early diagnosis and evaluation of tumors.

MRI can help determine if a cancer is limited to one area of the breast, or if it is "multicentric" and involves more than one area. Knowing this affects treatment choices, since mastectomy is necessary for multicentric disease. This is particularly useful for women with invasive lobular cancer, which has a tendency to be diffuse or multicentric.

In the case of metastatic breast cancer, MRI can evaluate other parts of the body. For example, a woman who has progressive back pain, or who develops new weakness or numbness in the arms or legs (not just hands or feet), can have an MRI scan of her back. The scan can help identify serious conditions such as the possible presence of a spinal tumor or brain metastasis.

MRI has been used successfully in women who have breast cancer cells in an underarm lymph node, but have no breast mass that doctors are able to feel or see on a mammogram. In these cases, where mastectomy is typically recommended, MRI can help find the precise site of the cancer's origin within the breast. Finding the cancer's precise origin can expand a woman's treatment options from only mastectomy to include lumpectomy plus radiation.

Patient Preparation

Please to sure to bring your mammogram films, unless you are a patient of the Women’s Imaging Center.

Please make the physician and/or technologist aware of the following information:

• The date of last menstrual period
• If you are post menopausal
• If you are pregnant or experiencing a late menstrual period
• If you are you taking oral contraceptives or receiving hormonal treatment
• If you are you taking any type of fertility medication or having fertility treatments
• If you are you currently breastfeeding

Breast MRI is an exceptional tool for breast cancer diagnosis and staging, however, this technology must be administered by experienced practitioners who understand its appropriate uses and limitations. Radiology & Imaging Specialists has extensive experience in all facets of breast imaging and MRI. Our board certified radiologists, technologists, and specialized equipment offer state-the-art breast imaging and interpretations.