Bilateral Breast MRI Frequently Asked Questions
Which Diagnostic Imaging Associates location offers Breast MRI?
What is Breast MRI and how is the procedure done?
Why should I choose DIA for my Breast MRI exam?
Why is DIA's Bilateral Breast MRI unique?
What is Computer-Aided Detection (CAD), and how does it enhance breast MRI?
Why is the gadolinium necessary?
What are some common uses of Breast MRI?
Am I a Candidate for Breast MRI?
I have breast implants - can I have a Breast MRI?
Clinical Indications for Breast MRI
Is Breast MRI a better test than mammography?
Is Breast MRI safe?
What should I wear to my appointment?
How long does it take?
How should I prepare?
Which Diagnostic Imaging Associates location offers Breast MRI?
DIA's MRI of Wilmington location is proudly serving the fight against breast cancer, utilizing state-of-the-art Bilateral Breast MRI. (302) 427-9855 • 1020 N. Union Street • Wilmington, DE 19805.
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What is Breast MRI and how is the procedure done?
MRI is a non-invasive method of medical imaging in which the patient’s area of interest is viewed in extremely thin segments from multiple directions, providing computer-generated images. The radiologist can then “page through” the tissue or create a three-dimensional image. No radiation is involved, and there is no flattening or compression of the breast. The patient lies face-down on a special table so the breasts are suspended through an opening into unique “coils” that transmit and receive the radio frequency signals used in MRI. Once positioned, the patient is moved feet first into the magnet so he/she can still look to the outside. DIA's MRI has a large opening to alleviate feelings of claustrophobia. Earplugs and/or music are provided to diminish the sound of the MRI. An IV line is established beforehand to allow injection of the gadolinium contrast.
Why should I choose DIA for my Breast MRI exam?
DIA has 25 years experience in breast imaging (mammography and breast ultrasound) and 5 years of experience in Breast MRI. DIA Board-Certified Radiologists, Technologists, and specialized equipment offer state-of-the-art MRI exams. By correlating the patient's Breast MRI with other studies including Ultrasound and Mammography, we are able to provide the most accurate diagnosis. DIA's Bilateral Breast MRI technology generates exceptionally detailed images of breast tissues. It is an extremely accurate method of disease detection throughout the breast and surrounding anatomy. DIA's MRI determines the extent of the disease bilaterally and reveals lymph node involvement. The goal of this advanced technology is to allow detection of new breast cancers at earlier stages and enhance the management and care of our patients.
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Why is DIA's Bilateral Breast MRI unique?
With DIA's Bilateral Breast MRI, a patient needs only one visit, and one exam. While DIA has been one of the only facilities in the region providing MRI of the breast for a number of years, a recent upgrade to GE's VIBRANT software has allowed for significantly improved resolution and faster scanning for bilateral breast exams. Contrary to having the study performed on other MRI scanners – DIA's patient does not require two exams, and two injections of contrast, on two separate days. DIA now provides patients with high-definition bilateral breast imaging in one patient visit – in one exam.
DIA's VIBRANT technology employs a unique scan procedure that thoroughly analyzes all parts of the breast tissue within minutes. With absolute confidence, DIA Radiologists utilize the system's bilateral breast imaging technique because it is the most sensitive to the patient's diagnostic needs.
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What is Computer-Aided Detection (CAD), and how does it enhance breast MRI?
Computer-aided-detection (CAD) plays a significant role in improving quality, efficiency, and standardization in women's imaging programs. Diagnostic Imaging Associates utilizes CADstream™, the first CAD application designed exclusively for MRI. CADstream assists DIA Radiologists in the interpretation and reporting of data-intensive Breast MRI studies. The system automates image processing functions – for example, CADstream allows your DIA Radiologist to create thousands of customized images with the ability to localize lesions with 3D navigation. The result is more standardized image processing and analysis, higher quality images and more rapid interpretation of the MRI study. The use of CAD ultimately makes breast MRI more accessible to women who would benefit from this valuable study.
CADstream is the standard in CAD for MRI. The system incorporates the American College of Radiology's recommendations and the BI-RADS® Atlas (Breast Imaging Reporting and Data System) for lesion classification. CADstream is the only CAD for MRI product on the market that incorporates ACR standards.
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Why is the gadolinium necessary?
Breast cancers have a rich blood supply, so tumors “light up” on MRI, helping to distinguish them from normal breast tissue. These are called areas of “enhancement.” It is the contrast agent, gadolinium that makes Breast MRI sensitive in cancer detection. When there is no enhancement, the radiologist can exclude the possibility of a lesion with about 95 percent confidence. Gadolinium is not the same as x-ray dye which contains iodine, and the likelihood of negative reaction is negligible.
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What are some common uses of Breast MRI?
- evaluate abnormalities detected by mammography.
- identify early breast cancer not detected through other means, especially in women with dense breast tissue and those at high risk for the disease.
- screen for cancer in women who have implants or scar tissue that might jeopardize an accurate result from a mammogram.
- determine the integrity of breast implants.
- distinguish between scar tissue and recurrent tumors.
- assess multiple tumor locations.
- check the progress of chemotherapy.
- look for multiple tumors prior to breast conservation surgery.
- determine whether cancer detected by mammography or ultrasound has spread further in the breast or into the chest wall.
- determine how much cancer has spread beyond the surgical site after a breast biopsy or lumpectomy.
- provide additional information on a diseased breast to make treatment decisions.
Am I a Candidate for Breast MRI?
Anyone (yes, men too) can have a Breast MRI exam. Clinical studies using Breast MRI have demonstrated great reliability in detecting invasive breast cancer, with reported sensitivities approaching 100 percent. If you are at high-risk for cancer, newly diagnosed with cancer or have undergone treatment for cancer, talk to your physician about the role of MRI in your care.
- Currently, most Breast MRI candidates are women who already have a cancer diagnosis and plan to have surgery or chemotherapy followed by surgery.
- Other candidates are those with a suspicious lump or mammogram, who are also going on to have a biopsy or surgery.
- Women may also be candidates if they have dense breasts, scar tissue from previous breast surgery or implants, which may prevent mammography from providing an adequate picture of the breast.
- Some Breast MRI studies include women who are at high risk for breast cancer (due to a previous cancer diagnosis, strong family history for breast cancer or a positive test for one of the breast cancer genes).
I have breast implants - can I have a Breast MRI?
Yes, Breast MRI is sometimes used to image silicone breast implants. If you have breast implants, it is important that you tell the DIA scheduler prior to your exam. We will also need to know if your implants are filled with saline, silicone or oil, or a combination of these. In addition, we need to know if the implant has a polyvinyl chloride sponge covering. Please get this information from your plastic surgeon’s office prior to your MRI exam.
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Clinical Indications for Breast MRI
- Lesion Characterization – Breast MRI may be indicated when other imaging examinations, such as ultrasound and mammography, and physical examination are inconclusive for the presence of breast cancer. Breast MRI may be helpful in patients who have had previous surgery for breast cancer, to distinguish between postoperative scarring and recurrent cancer. Other conditions that may impair conventional breast imaging, such as silicone augmentation or dense breasts, may warrant Breast MRI depending on the clinical findings.
- Neoadjuvant Chemotherapy – Breast MRI may be employed before, during, and/or after a course of chemotherapy to evaluate chemotherapeutic response and the extent of residual disease prior to surgical treatment.
- Infiltrating Lobular Carcinoma – Physical examination, mammography, and ultrasound may be limited in the evaluation of infiltrating lobular carcinoma. Breast MRI may be indicated for evaluation of extent, multifocality, and multicentricity.
- Infiltrating Ductal Carcinoma – Breast MRI may be indicated in order to determine the extent of disease, particularly in breast conservation candidates. MRI determines the extent of disease more accurately than standard mammography and physical examination in many patients.
- Axillary Adenopathy, primary unknown – MRI may be indicated in patients presenting with axillary adenopathy and no mammographic or physical findings of primary breast carcinoma. In patients with breast cancers, Breast MRI can locate the primary tumor and define the disease extent for definitive therapy. A negative Breast MRI may exclude the breast as a potential primary site of cancer and avoid a mastectomy that would provide no treatment benefit.
- Post-Mastectomy Breast Reconstruction Evaluation – Breast MRI may be indicated in the evaluation of suspected cancer recurrence in patients with tissue transfer flaps or implants.
- Breast Augmentation – Breast MRI may be indicated in the evaluation of patients with silicone implants and/or injections in whom mammography is difficult, and in patients with non-silicone implants. In these settings, Breast MRI may be helpful in the diagnosis of breast cancer and in the evaluation of implant integrity and rupture.
- Invasion Deep To Fascia – MRI evaluation of breast carcinoma prior to surgical treatment may be indicated in both mastectomy and breast conservation candidates.
- Contralateral Breast Examination In Patients With Breast Malignancy – MRI can detect unsuspected disease in the contralateral breast in at least 4% - 5% of breast cancer patients. This is often in the face of negative findings on mammography and physical examination.
- Post-Lumpectomy For Residual Disease – Breast MRI may be used in the evaluation of residual disease in patients who have not had preoperative MRI and whose pathology specimens demonstrate close or positive margins for residual disease. MRI can evaluate for multifocality and multicentricity to help determine which patients could be effectively treated by re-excision or whether a mastectomy is required due to the presence of more extensive disease.
- Surveillance Of High-Risk Patients – Recent clinical trials have demonstrated that Breast MRI can significantly improve the detection of cancer that is otherwise clinically and mammographically occult. Breast MRI may be indicated for women with a genetic predisposition to breast cancer.
- Recurrence Of Breast Cancer – Breast MRI may be indicated in women with a prior history of breast cancer and suspicion of recurrence when clinical and/or mammographic findings are inconclusive.
Is Breast MRI a better test than mammography?
Breast MRI is not to replace mammography, which has saved many lives from breast cancer. Instead it provides a powerful supplementary tool for detecting and staging breast cancer. The two tests are both great exams, each with their own strengths. Most commonly, Breast MRI is performed to answer a specific question raised from the patient’s mammogram. Breast MRI is a more sensitive test in detecting breast cancer than mammography. There are some cancers that can be seen with MRI that cannot be seen with mammography. This is especially true in patients who have dense breast tissue. Regardless of breast density, if a breast cancer is present, Breast MRI can detect it greater than 95% of the time, while mammography can detect cancer approximately 80-90% of the time. If the patient has dense breast tissue, the rate of detection of cancer can go down to as low as 50% by mammogram alone. For this reason, Breast MRI can be quite helpful in this sub-group of patients who have dense breast tissue on their mammograms and a change in their mammogram, a palpable lump or a biopsy-proven cancer. (Note: If you have dense breast tissue it is likely that DIA's Digital Mammography will provide better imaging quality for you than a conventional mammography).
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If MRI is a more sensitive test than mammography, can I just have this test instead of a mammogram each year?
No. All Breast MRI’s should be read in conjunction with the patient’s mammogram. Both mammography and MRI have different strengths. For example, mammography is better at detecting very tiny calcifications, which can be an early sign of breast cancer. Breast MRI is not to replace mammography, which has saved many lives from breast cancer. Instead it provides a powerful supplementary tool for detecting and staging breast cancer.
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Is Breast MRI safe?
Yes. MRI examination poses no risk to the average patient.
People who have had heart surgery and people with the following medical devices can be safely examined with MRI:
- Surgical clips or sutures
- Artificial joints
- Staples
- Most heart valve replacements
- Disconnected medication pumps
- Vena cava filters
- Brain shunt tubes for hydrocephalus
Some conditions may make an MRI examination inadvisable. Tell your doctor if you have any of the following conditions:
- Heart pacemaker
- Cerebral aneurysm clip (metal clip on a blood vessel in the brain)
- Implanted insulin pump (for treatment of diabetes), narcotics pump (for pain medication), or implanted nerve stimulators ("TENS") for back pain
- Metal in the eye or eye socket
- Cochlear (ear) implant for hearing impairment
- Implanted spine stabilization rods
- Severe lung disease
- Uncontrolled gastroesophageal reflux (a condition causing severe heartburn)
In addition, tell your doctor if you:
- Are pregnant
- Weigh more than 250 pounds (DIA welcomes a patient site-visit to ascertain if weight will prohibit the study.)
- Are not able to lie on your stomach for 30 to 60 minutes
- Have claustrophobia (fear of closed or narrow spaces)
What should I wear to my appointment?
Please dress comfortably— sweatpants and sneakers are perfect. It is important to not wear clothes with metal zippers, buttons or snaps; no metal is allowed in the MRI exam room. Safety pins, straight pins, metal hair pins and all jewelry must be removed before entering the room.
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How long does it take?
The average Breast MRI exam takes about 30 to 45 minutes.
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How should I prepare?
There is no pre-exam preparation—you may eat and drink as you normally would and take medications as you normally would.
- Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Metal and electronic objects can interfere with the MRI's magnetic field and are not allowed in the exam room.
- Jewelry, watches, credit cards and hearing aids, all of which can be damaged.
- Pins, hairpins, metal zippers and similar metallic items, which can distort MRI images.
- Removable dental work.
- Pens, pocketknives and eyeglasses.
- In most cases, an MRI exam is safe for patients with metal implants, except for a few types. (see "Is Breast MRI safe?")
Tell the technologist if you have medical or electronic devices in your body, such as:
- Artificial heart valves.
- Implanted drug infusion ports.
- Implanted electronic devices.
- Artificial limbs or metallic joint prostheses.
- Implanted nerve stimulators.
- Metal pins, screws, plates or surgical staples.
