Breast MRI

What is MRI?

MRI stands for Magnetic Resonance Imaging (MRI), a painless diagnostic study that is non-invasive and produces precise images of the body’s anatomy and internal organs without the use of x-rays and radiation. MRI generates high-resolution images that appear as a slice of the body’s anatomy. These highly-detailed images are produced using a large magnet, radio waves and a computer. MRI is also capable of producing images in an infinite number of projections throughout the body including the brain, nerves, spinal cord,musculoskeletal areas (bones and joints), breasts, and abdominal/pelvic organs. These images are useful in the early discovery and treatment of many conditions and diseases.

What Is Breast MRI?

Breast MR Imaging uses MRI technology for the detection, evaluation and follow-up of breast cancer. Many studies have shown that it is the technique that is most sensitive for the detection of breast cancer. Your physician can make the best determination if you are a good candidate for this study. Breast MRI is particularly useful for surveillance of high risk patients with the BRCA-I and BRCA-II gene mutations and for women with an unusually strong family history of breast cancer. It is important to note that Breast MRI does not replace annual screening mammography; as some cancers may only be seen on the mammogram. Breast MRI should be viewed as a complementary procedure to mammography and ultrasound.

What Happens During The Exam?

A registered technologist will position you on a padded scanning table which slides into the MRI magnet where the imaging is performed. You will lie face down on your stomach with your breasts positioned into cushioned openings, which are surrounded by a breast coil. The breast coil is a signal receiver that works with the MRI unit to create the images.

An initial series of images will be taken. The patient is then given an intravenous injection of a special contrast material (called gadolinium) that helps to highlight various areas in the breast tissue. Several additional sets of images will follow. During the exam, you will need to lie very still and breathe normally. The technologist will offer you headphones to listen to music and help you relax. As the equipment scans, you will hear peculiar banging noises from the magnet which are completely normal. You may feel a slight vibration or warmth. It is important to remember that the WRA technologist can see and hear you at all times. A Breast MRI study usually takes about 45 minutes.

Is MRI Safe?

Because MRI does not use x-rays, it presents no apparent risk to adults and children. If you are pregnant or nursing you should consult your physician before having any MRI scan.

Who Performs An MRI?

A registered MRI technologist will assist you in preparing for the exam and positioning you on the table. The exam will be conducted based on the direction from a WRA board-certified radiologist skilled in the interpretation of Breast MRI.

How Will I Learn About The Results Of My Study?

Results of your MRI may not immediately be available due to the significant number of images taken during your exam—up to 1600 images are acquired of each breast. The radiologist will review your study typically the same day and a report will be sent to your physician within 24 to 48 hours. Your physician will then review the results of the study with you.

How Do I Prepare For An MRI?

There is very little preparation required for a Breast MRI. The timing of the study should be closely linked to the menstrual cycle for women who are premenopausal. The best time to perform a Breast MRI is between days 6 and 12 of your menstrual cycle (day one is the day that your period arrives). For patients who are postmenopausal, the examination can be performed at any time. For those who are perimenopausal, it is optimal to wait for the next cycle to start, and schedule between days 6 and 12. If the menses occur only rarely, then the examination can be scheduled at any time with the understanding that residual hormonal activity can render the examination difficult to interpret. A medical history will be taken by the MRI technologist. You should plan to not eat for the 4 hours prior to your exam. If needed, you may have clear liquids up to 2 hours before your study. Also:

• Continue to take any medications prescribed by your doctor unless otherwise directed.
• Wear comfortable two-piece clothing without metal zippers, buttons, hooks etc.
• Because of the magnetic field,we also ask that you not wear any metal hair clips or eye makeup which may contain small metallic flecks which can interfere with your scan. A secure locker will be available to leave coins, jewelry,watches, eyeglasses, credit cards, keys, hairpins, and other metal objects in a safe place.

If you have any questions regarding the preparation, please call the WRA office where your exam is scheduled and ask to speak with an MRI technologist.

What is Breast MRI-Guided Biopsy?

Breast MRI has a high sensitivity for the detection of breast cancer. Often, suspicious lesions are found that are not detected with mammography and/or ultrasound, and an MRI-guided biopsy is recommended. The radiologist performing the biopsy uses the information from the MRI to identify the tissue that should be sampled. As with stereotactic and ultrasound guided biopsies, small samples of tissue are obtained through a very small skin incision. This procedure is performed by a skilled radiologist in the MRI suite and takes just 35 to 45 minutes. This procedure allows for detection of even the smallest lesions at the earliest possible stage of development.

Can Anyone Have An MRI?

There are some conditions that are not conducive to high-field MRI. Our staff will speak with you when you make an appointment and make sure you do not have any of these conditions, which may include:

• History of a heart pacemaker
• History of an artificial heart valve
• Severe claustrophobia.

Does Insurance Cover Breast MRI?

Most health plans require pre-certification for Breast MRI studies, and certain clinical indications may be required for coverage. Always check with your insurance carrier prior to scheduling any radiology exam.

What Are The New American Cancer Society (ACS) Guidelines For Breast MRI?

The ACS recommends an annual Breast MRI for women who meet at least one of the following conditions:

• BRCA1 or BRCA2 gene mutation OR first-degree relative with BRCA 1/2 (even if patient not yet tested)
• Lifetime risk of breast cancer scored at 20–25% or greater (generally corresponds to two 1o relatives with breast cancer)
• Radiation to the chest between the ages of 10 and 30
• Li-Fraumeni/Cowden/Bannayan-Riley-Ruvalcaba syndromes, or patient may have one syndrome based on history in 1o relative

Annual screening Breast MRI may be beneficial but is not currently routinely recommended for women who have:

• Lifetime risk of breast cancer scored at 15–20%
• Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH)
• Atypical ductal hyperplasia (ADH)
• Very dense or unevenly dense breasts (on mammogram)
• Already had breast cancer, including ductal carcinoma in situ (DCIS)

For more information, please consult with your physician.

Videos

Peter Dunner, MD, radiologist at Washington Radiology Associates, discusses breast health with "Watch News Channel 8 Live!" anchor Dave Lucas on the mid-day show. Watch Now.
January 6, 2009

WRA MRI Centers

Washington, DC

University Medical Building
2141 K Street,NW
Suites 100 & 111
Washington, DC 20037
202-785-4674

Northern Virginia

Four Seasons Three
3022 Williams Drive
Suite 104
Fairfax,Virginia 22031
703-698-8800

Suburban Maryland

Chase Tower
4445 Willard Avenue, Suite 200
Chevy Chase,Maryland 20815
301-654-4242

Scheduling Appointments

Washington Radiology provides imaging services for patients upon referral from a physician. Patients are seen by appointment. However, emergencies do occur and we make every attempt to accommodate these cases. To schedule your MRI study at Washington Radiology, please call: (703) 280-9800,