Breast MRI is a new imaging technique that is used for certain women at very high risk for cancer, whose breast tissue can’t be fully evaluated in the usual ways. In some of these women, clinical exam, self breast exam,  mammogram, and ultrasound alone may not give enough useful information.  MRI isn’t recommended as a substitute for screening or diagnostic mammography.

For women with diagnosed breast cancer, MRI provides enhanced detection in the breast known to have cancer and the opposite, or "contralateral," breast. Surgical decisions should not be based solely on MRI findings because not all suspicious lesions on MRI are cancerous. Suspicious lesions should be biopsied before a surgery plan is devised in order to avoid surgical overtreatment. In the rare instances where cancer is found in the lymph nodes but not the breast, an MRI can find the location of cancer in the breast in nearly 60 percent of women.

MRI of the breast used in conjunction with mammography now offers an extremely sensitive image to help resolve the unknown or inconclusive result from a mammogram or ultrasound. This exam does require an injection of a small amount of contrast which enhances the areas within the breast and highlights any areas of concern for abnormality.

Who might benefit from Breast MRI?

• Women with at least two first degree relatives, such as mother and sister with invasive breast cancer, when one of them was found before age 40.
  
• Women with certain very rare genetic or medical conditions that cause a high risk of cancer.

• Certain women with breast cancer, MRI can help plan surgery when it is not clear that the breast can be saved and full removal (mastectomy) might be needed instead.

• Women with silicone gel implants to detect possible leaking of the implant.

Breast MRI

Best results are obtained if scheduled between days 5 -11 from the start of        
your menstrual cycle.

MRI Safety

Magnetic Resonance Imaging (MRI) is a way of obtaining very detailed images of organs and tissues throughout the body without utilizing radiation. Instead, MRI utilizes a powerful magnetic field, radio waves, a rapidly changing magnetic field, and a computer to demonstrate whether or not there is an injury or some disease process present. An MRI exam causes no pain, and the magnetic fields cause no known tissue damage or side effects. However, the powerful magnetic field of the MR system will attract iron-containing (ferromagnetic) objects or cause them to move suddenly and with great force. This includes items in the body (aneurysm clips...) or external objects. Other metallic implants or objects may distort the MRI images. In addition, some MRI exams may require the injection of a contrast material called gadilinium into a vein to help interpret the exam. Although gadilinium does not contain iodine, recent findings have shown the gadilinium-based contrast agents increase the risk of nephrogenic system fibrosis (NSF) in certain patients.

For these reasons, great care is taken to ensure your safety. All MRI patients are asked the following questions:

MRI Screening Questions:

1. Is this your First MRI? ____ If no, where was the previous MRI performed? ____
2. Was the previous MRI for the same problem?______
3. What is your weight? _____ (If between 330 - 550 lbs, you should be scheduled at Blue Ridge or Cedarhurst location. If under 330, you can be scheduled at Cary, Wake Forest or Clayton facilities.)
4. Have you ever sought medical treatment for getting metal fragments in your eyes or had significant exposure to welding, grinding or soldering due to your profession or hobby? If yes, an orbit x-ray will be done free of charge prior to your scan. These x-rays are done on a walk in basis during the following hours:
   • Blue Ridge Mon – Fri 8am – 5:15 pm              • Cary Mon – Fri 8:30am-4:45 pm
   • Cedarhurst Mon – Fri 8am – 5:00 pm              • Wake Forest Mon – Fri 8am-5 pm
5. Have you ever had any type of cancer? ___ If yes, what type and when were you diagnosed?___
6. Are you claustrophobic? ___ If yes, you should be scheduled at the Open Bore MRI locations at Blue Ridge or Cedarhurst. If you and your physician determine that a sedative (such as Valium) is needed for this procedure, you must arrive prior to your scan to complete paperwork and you MUST bring a driver.
7. Do you have renal failure? ___
8. Are you over 60 yrs old? ____ Are you diabetic? ____ Do you have high blood pressure? ___ If so, we must have labs with a Creatinine to determine GFR. (Labs are considered current within 90 days)
9. Do you have any implanted devices such as Aneurysm clips, insulin pumps, TENS unit, epidural drug delivery, artificial heart valve, defibrillator or a Pacemaker? ____ (If yes, you probably cannot have a MRI or your physician must provide us documentation with make and model of implanted devices )
10. Have you had surgery in the last 6 weeks? ___ If yes, what kind?___ (We suggest you schedule 6 weeks after your surgery)
11. Have you ever had any surgery on the area being scanned? ___ If yes, when?___
12. Do you have a chest port for IV access? ____ If yes, we do not have a nurse to inject contrast into a port – we must inject the patient.
13. Please bring a list of all medications you are currently taking.
14. Is there chance you could be pregnant? _____
15. Does this exam require pre-authorization from your insurance? ____

In addition, breast MRI patients are asked the following to ensure the most conclusive test results.

1. Reason for the exam?

•  Screening due to high risk (must have mammogram within 12 months)
•  Implant integrity/ rupture (must have a mammogram within 6 months)
•  Newly diagnosed breast cancer (mammogram within 6 months)

2. Do you have breast implants? Silicone, saline, or both____________ What year did you get them?
3. What is the address and phone number where you had your last mammogram? ___
4. Have you had a breast MRI before? If so, where? ____________
5. Are you a high risk patient?________ Have you tested positive for the BRCA gene? ________
6. Last Menstrual Period ___________ If you have tested positive for the BRCA gene, it is best to
    schedule the MRI between the 5th and 11th day of the cycle.
7. Have you had a previous breast biopsy or breast surgery? When and which breast? Please have
    the results faxed to our office. _______________
8. Have you had chemotherapy or radiation therapy?_____________