Mammogram screening: breast MRI for cancer diagnostics

Medically reviewed: 27, October 2023

Read Time:7 Minute

MRI scan of mammary glands

Magnetic resonance imaging (MRI) of the mammary glands is a diagnostic method for layered visualization of breast tissue, based on the use of magnetic field properties. With the help of MRI of the mammary glands, it is possible to identify a tumor focus, clarify the prevalence of the process, diagnose metastases and relapse of breast cancer, rupture or leakage of breast implants.

MRI data are indispensable in the planning of treatment tactics (including operations) and postoperative control. A feature of magnetic resonance imaging of mammary glands is the image in various planes, the possibility of dynamic contrast and the absence of radiation load.

MRI of the mammary glands is a method based on the use of powerful magnetic radiation, radio waves and software processing of information for the visualization of soft tissue of the breast. MRI allows you to examine the tissue of the breast by layer, polypositional and polyprojection.

If you want to learn about other options, check information about CT-scan of the breast (breast X-ray)

MRI is a more modern study compared with breast ultrasound and mammography and complements their data. The advantage of MRI is the possibility of simultaneous visualization of both mammary glands, the absence of ionizing radiation, high contrast, which makes it possible to clearly differentiate the structure of glands and the nature of pathological changes.

MRI of the breast can be performed in two versions: without contrast (natively) and against contrasting background. According to the native breast imaging, the density of breast tissue is determined, cystic formations, dilated milk ducts, hematomas, ruptures of breast implants. Contrast MRI of the mammary gland is aimed at revealing the location, size and nature of the neoplasm, as well as the detection of enlarged lymph nodes.

Magnetic resonance imaging (MRI) of mammary glands with contrast is a noninvasive diagnostic technique that allows obtaining a clear image of breast tissue due to the electromagnetic field and contrast enhancement. MRI of mammary glands with intravenous contrast imaging reveals pathological neoplasms and vessels feeding them, allows to estimate the sizes and localization of tumors, differentiate their benign or malignant character, identify enlarged lymph nodes, etc. Contrast enhancement increases the informative value of MRI in recognition of breast cancer to 90-95% .

Mammogram screening: Indications for MRI

Mammography is usually preceded by mammography or ultrasound. Indication for MRI of the breast is determined by an oncologist or mammologist. With the help of MRI of the mammary gland, the nature of the formations revealed by ultrasound or mammographic screening is specified.

Conducting MRI of the mammary gland is preferable to mammography in women under 35 years of age. Through MRI, early detection of sarcoma and breast cancer in the size of up to 0.5 cm, unavailable for visualization in other ways, can be detected early.

Mammologist uses MRI of the breast to plan the volume of surgical interventions; postoperative observation of patients who underwent a mastectomy, radical resection of the gland, for the purpose of early detection of relapse; evaluation of tumor spread to the thoracic wall; tracing dynamics during chemotherapy.

Breast images can be used for visualization during breast biopsy. The annual breast MRI is recommended for women with increased on-care: in the presence of genes associated with breast cancer (BRCA1, BRCA2) in the patient or the next of kin (daughters, sisters, mothers); after the radiotherapy and other risk factors transferred at the age of 10-30 years.

For women who have silicone breast endoprostheses, MRI is the preferred method of screening, since the possibilities of mammography in this category are limited. In addition, MRI of the breast can monitor the integrity of the implants, detect rupture of the shell and leakage of the gel.

MRI of the breast: Contraindications

MRI of the breast is contraindicated in the presence of internal metal and electromagnetic devices – cardioverter defibrillator, pacemaker, cochlear implant, vascular clips, etc. MRI of the breast is difficult in patients with claustrophobia, expressed obesity, unable to maintain immobility during the study. MRI of the breast can not detect calcification of tissues or tumors.

When planning MRI of the breast with contrasting, the fact of tolerability of contrast medium with gadolinium is specified. In diseases of the kidneys or sickle-cell anemia, contrasting is contraindicated. In pregnancy, MRI of the breast is performed only if its diagnostic benefit exceeds the potential risk of exposure to the fetus. If a contrast MRI of the breast is performed during lactation, breastfeeding should be discontinued for 36-48 hours.

It is forbidden to carry out MRI if a woman has such devices:

  • built-in pacemaker;
  • cochlear implant;
  • some types of intravascular stents;
  • clips used for aneurysms of the brain.

If there is any electronic or medical device on the body, it is necessary to inform the specialist. It can be:

  • artificial heart valve;
  • a port for the introduction of medicines;
  • the driver of a warm rhythm;
  • a neurostimulator;
  • arthroplasty of joints;
  • surgical staples, plates, pins, etc.

The presence of these devices does not exclude the MRI, but carries a certain risk and may affect the result of the study.

The patient should definitely notify the technologist about:

  • presence of any metal implants (including dentures, intrauterine device);
  • permanent eyeliner, the presence of tattoos;
  • pregnancy (harm procedure for the fetus is not confirmed, but the study is only if there are good reasons);
  • recent surgery on blood vessels;
  • diseases in which the use of contrast medium is contraindicated (for example, kidney failure);
  • presence of a medical plaster on the body (may cause burns);
  • allergies to the contrast drug used during the procedure.

Breast MRI: Method of conducting

For the purpose of the most informative MRI of the breast is carried out in the first half of the menstrual cycle (on days 7-12), in postmenopausal women – at any time. Before entering the MR room, the patient is asked to remove clothing with metal parts, ornaments, hearing aids, glasses, watches, etc. metal-containing items.

To perform MRI of the mammary gland, the patient is placed on a stationary study table on the abdomen; the mammary glands are placed in special holes surrounded by a spiral, which receives signals from the apparatus. To maintain the desired position, rollers and belts can be used during MRI.

If a contrast enhancement is required during breast MRI, the drug is administered via an intravenous catheter. During the study, the patient is placed in the cylindrical magnet of the MR scanner, where a series of scans is performed. The total duration of MRI of the mammary glands takes from 30 to 60 minutes.

During an MRI, a woman can experience:

  • a local temperature increase;
  • discomfort due to the inability to move for a long time;
  • an attack of claustrophobia (if a woman is afraid of an enclosed space, sedatives must be taken before the procedure);
  • feeling of slight burning during the injection of the contrast drug;
  • the taste of metal in the mouth after the injection.

After the introduction of a contrast agent, it is not recommended to breast milk for up to 2 days, but harm is not proved if this advice is not observed. Pregnant women can not undergo an MRI with contrast.

Mammary glands MRI: Method Restrictions

When observing the research technique and recommendations, MRI of the breast does not pose risks to patients. The introduction of contrast can be accompanied by a brief feeling of heat or cold, which soon passes. All sensations or changes in the state during breast MRI can be reported to the staff by contacting him using the call button.

After removal of the intravenous catheter, a hematoma can form; Infection occurs less often at the injection site. In rare cases, after using contrast, nausea, itching of the skin, eyes, urticaria are noted.

MRI-diagnostics of mammary glands is a rather expensive method, requires the availability of specialized equipment and trained personnel. Despite the high specificity and sensitivity, MRI of the breast often gives erroneous false positive results and does not reveal calcifications in the tissues.

The use of a powerful magnetic field and electromagnetic radiation limits the use of MRI of mammary glands in a large group of patients, so the method can not serve as a screening diagnosis.

The cost of breast MRI in USA

The cost of the MR-study includes scanning, performing all accompanying manipulations and preparing documentation, including a medical report. For the use of contrast medication, the patient pays an additional fee (50 percent or more of the cost of the procedure depends on the institution and type of contrast).

The recording of the results of tomography on an electronic carrier is not included in the price of the MRI of the mammary glands (it depends on a state) in USA and is paid for separately. The cost of the procedure is influenced by the location and reputation of the clinic, its organizational and legal status and the qualification of the doctor preparing the conclusion.

Leave a Reply

Your email address will not be published. Required fields are marked *