Understanding MRIs of the breast

Magnetic Resonance Imaging, also known as MRI, uses high-powered magnets, radio waves and a computer to produce detailed images of the body. It is especially useful when visualizing organs, soft tissues and bones. Unlike an X-ray, MRI does not use ionizing radiation.

Breast MRI for High-Risk Groups

For women who are at high risk of developing breast cancer, MRI along with screening mammograms can be an important tool in the early detection of breast cancer. The American Cancer Society recommends that women who have a lifetime risk of developing breast cancer that is greater than 20 percent receive a breast MRI in addition to their annual screening mammograms. Women at moderate risk (15 to 20 percent lifetime risk) should talk to their doctors about whether they should have an MRI.

Women in any of these categories are considered at high risk for breast cancer:

Have a known BRAC1 or BRAC2 gene mutation,
Have a first-degree relative (mother, father, brother, sister or child) who has a BRAC1 or BRAC2 gene mutation even if the woman does not have one herself,
Have a 20 percent or greater lifetime risk of developing breast cancer as determined by risk assessment tools that are primarily based on family history,
Had radiation to the chest between the ages of 10 and 30, or
Have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvacaba syndrome, or have a first-degree relative who has one of these syndromes.

Women at moderate risk may have:

A lifetime risk of breast cancer between 15 and 20 percent based on risk assessment tools based mainly on family history,
A personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH), or
Extremely dense breasts or unevenly dense breasts when viewed by mammograms.

Breast MRI

Breast MRI can be performed with or without a contrast (dye) material. The contrast material is injected into a vein so that it enters the blood stream. In some cases, an MRI may be done before and after the contrast material is used.

The MRI without contrast can be used to look at the density of the breast tissue, cysts, enlarged ducts, hematomas (bruising), and leaking or ruptured breast implants. Once contrast is added, the MRI can show breast abnormalities including their size and location. It can help determine whether abnormalities need further studies to determine if they are benign or malignant. A contrast MRI also can show any enlarged lymph nodes.

Benefits and Risks

Overall breast MRI is more sensitive than mammography, however, it may miss some cancers that a mammogram would detect. For this reason, women at high or moderately high risk of breast cancer should continue to have their annual mammograms.

If you fall into one of the higher risk groups, your doctor may recommend that you begin having annual screenings at age 30. You should talk to your doctor about your risk factors and decide what’s right for you.

“Women who are not at higher risk should continue with their regular mammograms,” explains Lukas Burton, MD, radiologist on staff at Lake Pointe Medical Center. “While breast MRI has greater sensitivity than mammography, it can have a higher number of false positive results that would result in more testing like biopsies that are not needed. In addition, breast MRI costs more than a standard mammogram so it should only be used when medically necessary.”

Before having a test like an MRI, women should tell their doctor if they might be pregnant. You also should tell your doctor and the technologist who performs the MRI about any allergies you have including hay fever, hives, allergic asthma, or to any foods or drugs. Be sure your doctor and the MRI technologist know about your medical history including kidney disease and sickle cell anemia. These may mean that you should not have the test with contrast material.

To schedule a breast MRI, you will need a physician’s order. Breast MRIs are performed at the Lake Pointe Imaging Center in Forney. Call 469-689-1400 to schedule the procedure. We also offer CT, MRI, mammography, ultrasound, bone density and x-ray at this location should you require those services. Or visit our website at lakepointemedical.com for more information.