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MRI - Magnetic Resonance Imaging (MRI) of the breast is an exciting new diagnostic tool available for the detection of breast cancer, especially in women who are at increased risk of breast cancer or have a breast physical exam that is difficult to evaluate because of lumpiness or thickening. It is also useful for women who have questionable findings or very dense breast tissue on regular mammograms. An MRI provides the best possible means to assess the soft tissues of the body compared to other diagnostic tests.

MRI Technology

For many years, an MRI of the breast was the examination of choice for the assessment of breast implants. With recent technological improvements, MRI's can now show finer detail in the glandular tissue of the breast than ever. In order to be extremely accurate, sophisticated equipment and computer software is necessary. This test cannot be performed on all types of MRI machines and requires a magnet with high field strength and powerful computers. For this reason, breast examinations cannot be performed on an open MRI system.  State of the art MRI equipment should allow simultaneous scanning of both breasts in one visit.

Below are pictures of MRI equipment. The first an "Open Breast Coil" which is where the breasts rest during the exam The second is an MRI Scanner which shows the MRI machine in its entirety.

		Open Breast Coil. Click on the image for a larger view.
		MRI scanner. Click on the image for a larger view.

MRI Procedure

A typical breast MRI study takes about 30 minutes to perform and uses a special device called a "breast coil" to receive the image signals. This device actually looks just like a plastic pair of breast shaped cups. The breasts enter into the cups when a patient lies down on her stomach on the MRI scan stretcher for the exam.

The sensitivity of the test is due to the intravenous administration of a small dose of this MRI contrast agent known as gadolinium, which occurs during the final part of the test. It is used in many patients undergoing MRI exams of the brain, spine, or body. Gadolinium is extremely safe and allergic reactions are rare. The contrast highlights abnormal tissue in the breast, including cancerous tissue, making it stand out from normal glandular breast tissue even in the densest or lumpiest of breasts. Occasionally, normal tissue can enhance as well, so the radiologists interpreting these exams must have the experience to be aware of the normal variations associated with this type of study. A complete breast MRI examination includes comparison of the enhanced images with routine MRI scans, which show normal structures such as cysts and lymph nodes in the breast well.

MRI Guidelines

Many patients are now undergoing breast MRI exams. Breast MRI should not replace conventional mammography, physical examination, or breast ultrasound. MRI cannot be used instead of biopsy in patients with suspicious calcium deposits and it is not a routine screening study by itself. Most insurance carriers now do cover MRI examinations of the breast when a physician feels the study in necessary.

Below, two images from a Breast MRI study showing a large breast cancer on a routine scan and another picture after administration of Gadolinium contrast. The intense white enhancement is generally seen only in cancerous tissue.

		MRI image after contrast showing a large breast cancer. Click on the image for a larger view.
		MRI image before contrast showing a large breast cancer. Click on the image for a larger view.

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