Breast MRI is the most sensitive method for detection of breast cancer. Depending on international health regulations, it is either applied for screening of women at high risk for developing breast cancer (e.g. BRCA-1 and BRCA-2 carriers), as an additional diagnostic test in pre-therapeutic breast cancer staging, monitoring of primary systemic therapies and for solving problematic diagnostic situations were direct biopsy is not possible.
Just as mammograms are x-ray machines specially designed for the breasts, breast MRI also requires special equipment. While during classical whole-body MRI patient usually lies at the back, for a breast MRI, the woman usually lies face down, with her breasts positioned through openings in the table. In order to check breast positioning, the technologist watches the MRI through a window while monitoring for any potential movement. This MRI machine is called an MRI with dedicated breast coils, which not all hospitals and imaging centers have.
Rules, by which you should prepare for the examination, are basically the same as for classical MRI. About how to prepare for an MRI examination you can read more here.
What are the limitations of the breast MRI?
As within any MRI examination, you will be asked to lay as motionless as possible. High-quality images are assured only if you are able to remain perfectly still and follow breath-holding instructions while the images are being recorded. If you are anxious, confused or in severe pain, you may find it difficult to lie still during imaging. Also a very large person may not fit into the opening of certain types of MRI machines.
The presence of an implant or other metallic object sometimes makes it difficult to obtain clear images due to streak artifacts from the metallic objects.
Although there is no evidence that magnetic resonance imaging may be a threat for the fetus, pregnant women are advised not to have an MRI exam, unless it is necessary. More information about MRI risks during pregnancy and breastfeefing you can find in this article. In some cases, a non-cancerous piece of tissue in the breast can take up the contrast material and show up as a bright spot on the image. Often, the radiologist can tell by the appearance of the tissue whether it is cancer or not. When it is not clear, other testing such as ultrasound of that specific spot or a biopsy for histological evaluation may be needed.