XRA Medical Imaging is an accredited facility from the American College of Radiology in Rhode Island. Find information regarding our Breast MRI service below, and our office locations where a Breast MRI can be performed.
Breast cancer is the second leading cause of cancer deaths for women in the United States. Approximately 8.5 million women are at high risk for breast cancer.
Since 1999, there has been a 40% per year increase in the number of breast MRI examinations in the U.S. Breast MRI is primarily used for determining extent of disease (staging), monitoring response to therapy in breast cancer patients and screening high-risk patients.
Clinical research has reported that MRI demonstrates high sensitivity for detecting invasive breast cancer. Unlike other breast imaging modalities, which look at physical characteristics of breast tissue only, MRI looks also at how the tissue behaves. Malignant tissue tends to absorb an intravenously administered contrast agent at a higher rate than surrounding tissue, due to tumor angiogenesis.
Breast MRI has emerged as the most sensitive imaging modality for detection of invasive breast carcinoma. Extensive and ongoing research continues to expand the indications for this imaging procedure.
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Breast MRI is performed in an MRI machine
which creates a magnetic field around the
patient. The patient lies face down on the
table and the breasts fit into a hollow
depression. The table then slides into the
MRI unit and there is a loud tapping noise
once the exam begins. The magnetic field
cannot be felt and the patient has the option
of wearing earplugs or earphones to listen
to music to quiet the noise.
A contrast agent (dye) is injected into the
patient’s veins through an intravenous (IV)
line to enhance the appearance of tissues
and blood vessels in the breast MRI pictures.
During the test, the patient is constantly
monitored by a technologist. The technologist
is in another room but can see the patient
and speak with the patient during the entire
exam. The patient has a microphone and
hand buzzer to notify the technologist of any
questions or concerns. The entire procedure
takes approximately 45 minutes.
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Every Breast MRI study at XRA Medical Imaging
is processed with CADstream, a computeraided-
detection system, to assist our fellowship
trained Radiologists in analyzing and interpreting
all Breast MRI studies.
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An MRI guided biopsy of the breast is a
minimally invasive procedure that establishes
a precise diagnosis of a breast problem
without the need for surgical biopsy. MRI is utilized to localize the abnormality if not seen with a mammogram or with ultrasound. The procedure allows the Radiologist to remove a small amount of breast tissue for the pathologist to make a definitive diagnosis.
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- There is a history of breast cancer in your family or you have been personally diagnosed
with breast cancer.
- There is a questionable area on your mammogram.
- You have been diagnosed with breast cancer and your physician would like to determine
the extent of the cancer.
- There is a mass or lump that can be felt but is not detectable with a mammogram or
ultrasound exam.
- There is a mass or lump or change in your breast after radiation therapy that is not
detectable with a mammogram or ultrasound exam.
- Your breast tissue is dense and prior breast cancer was not detected with a mammogram.
- Your doctor would like to monitor your breast cancer.
- There is a suspected leak or rupture of a breast implant.
- You received chest radiation for Hodgkin’s disease before age 30.
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Lobular cancer: Difficult to detect by mammography, this insidious cancer is commonly multi-focal/multi-centric or bilateral (10%) and a frequent cause of positive surgical margins.
Occult breast cancer: About 0.3% of breast cancers present with malignant auxiliary nodes yet have normal breast exams and mammograms; hence standard treatment has been mastectomy. MR can locate the primary in the majority of cases, allowing breast conservation surgery.
Close or positive surgical margins: Inadequate margins are reported in up to 50% of lumpectomies, requiring additional resection. MR can often locate residual or additional tumor foci. If routinely used pre-operatively, as in Europe, MR can decrease re-operation rates and can be very useful for surgical planning in difficult or challenging cases.
Post-operative scar vs. tumor recurrence: At 6 months or more after surgery, “mature scar,” which may simulate cancer morphologically, does not enhance. Recurrent tumor does enhance and usually has a malignant type enhancement curve.
High risk screening: Breast cancer gene carriers; prior treatment for lymphoma: These women are at great risk for breast cancer. MR and ultrasound are valuable adjuncts to mammography for improved detection of breast malignancy in these high risk patients, but MR is not an appropriate exam for general screening.
Neo-adjuvant chemotherapy or brachytherapy: MR improves accuracy of the tumor size and staging as well as document tumor response and detection of multifocality/multicentricity.
Suspected multiple or bilateral cancers: MR readily shows multifocal or multicentric tumors, and has a high negative predictive value; i.e., a negative MR significantly improves diagnostic confidence. Unsuspected contralateral tumors may be detected in 5-10% of cases.
Implants and known or suspected cancer: MR is not adversely affected by implants or silicone. This improves diagnostic confidence and allows ultrasound-guided needle biopsy when needed. Women with a history of liquid silicone injections can benefit from MR screening. MR is also the most reliable exam for assessment of implant rupture.
Problematic mammogram: In carefully selected cases, MR may be helpful with equivocal or suspicious mammographic findings; detailed mammographic evaluation and ultrasound should be performed first, however.
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- Imaging performed between days 7 to 15 of the menstrual cycle is optimal.
- Hormonal replacement therapy should be discontinued for 3 months prior to imaging with MRI.
- Patients with BIRADS cat 5 lesions (highly suspicious for malignancy) and patients with biopsy-proven breast carcinoma should be imaged BEFORE lumpectomy.
- Post-treatment (surgery, radiation, chemo) MRI should be delayed as long as possible to minimize confounding treatment-related changes.
- Prior breast imaging studies will be needed for correlation in order to finalize the breast MRI interpretation.
- All studies are BILATERAL (except in case of prior mastectomy).
- To help make your appointment with us as convenient as possible, patients are encouraged to download, print and complete the Breast MRI Form prior to visiting our office.
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Understanding Breast MRI and cancer
