Key takeaways:
One in eight women will be diagnosed with breast cancer, making it the most common cancer for women after skin cancer. Thankfully, breast cancer treatments have come a long way, so more women can enjoy life long after receiving a breast cancer diagnosis.
A major factor in the success of breast cancer treatment is early detection. Self-breast exams and clinical breast exams, along with various breast imaging technology, can help to identify breast cancer early so treatment can be more effective. While most people are aware of mammograms, breast MRIs (and full-body MRIs) play a crucial role in detection.
Magnetic resonance imaging (MRI) uses magnets and radio fields to create images of the body’s soft tissues, bones, and organs. MRIs allow radiologists to look inside the body without the harmful radiation used during X-rays and CT scans.
A breast MRI is a specific type of MRI that provides detailed images of the breast.
Breast MRI machines have special breast coils that help create high-resolution and high-quality images of one or both breasts. These MRIs can create detailed, three-dimensional images of breast tissue, allowing radiologists to better identify any abnormalities.
Contrast often used with breast MRIs becomes concentrated in areas where there is cancer growth, providing more diagnostic clues than an X-ray or mammogram can.
During typical MRIs, patients lie on their backs while the MRI scanner takes pictures of their body. But during a breast MRI, you will lie on your belly with your breasts suspended in dedicated breast coils. These coils contain signals that are sent back to the MRI machine in order to make highly detailed images.
During breast MRIs, many facilities use gadolinium-based contrast dye, which is injected through an IV line in your arm. Contrast material is absorbed into soft tissues and the blood vessels of your organs to provide a more detailed and crisp image. Some people have allergic reactions to contrast dye or simply cannot tolerate it due to uncomfortable side effects. Talk to your radiologist about the risks and benefits of using contrast during a breast MRI.
Breast MRIs are painless, but they require you to lie still in the MRI tube. This can cause some people to become claustrophobic. In this case, taking a prescription medication beforehand can help calm your nerves. The technologist can give you pillows to help you get comfortable, as the MRI will last from 45 minutes to an hour.
The magnets in the MRI machine also make a rhythmic noise that can be annoying, so you might want to bring some earplugs too. The staff at ezra will play a Spotify playlist of your choosing to help pass the time during your MRI.
Since breast MRIs involve the use of a highly magnetic field, it’s important not to wear any metal during the procedure. You’ll most likely wear a gown, but make sure you take off any jewelry, metal hair clips, and bobby pins. For the same reason, people with pacemakers, metal clips in their body, or cochlear implants should talk to a health practitioner before scheduling an MRI.
The main difference between mammograms and a breast MRI is a mammogram uses X-ray images and a breast MRI uses magnets and radio waves. 2D mammograms use a very low dose of radiation to create two views of the breast.
Since mammograms use such a low dose of radiation, the breast is compressed with a flat plate to flatten and spread the breast tissue. Breast MRIs do not require this, thanks to the powerful breast coils used during imaging.
Breast MRIs are considered to be more detailed and more accurate than mammograms, but breast MRIs can miss some cancers a mammogram would find. Because of this, breast MRIs are used together with screening mammograms.
A breast MRI is used for a number of reasons, including routine screening for high-risk breast cancer patients (below, we’ll explain who belongs in this group), collecting detailed imaging if breast cancer is found, and obtaining a biopsy of breast tissue.
The American College of Radiologists (ACR) recommends women take a breast cancer risk assessment when they reach 30 years old. This can help determine the need for additional screenings.
Women with an average risk of developing breast cancer should start routine mammogram screenings every year starting at age 40, but those with a higher risk should start sooner.
Women at high risk for developing breast cancer should have an annual breast MRI along with their mammogram. This especially applies to younger women who have a high risk of developing breast cancer. An example of this is a woman in her teens or 20s who finds out she has a family member with a BRCA1 or BRCA2 mutation.
According to the American Cancer Society, women who are considered high risk should have annual breast MRIs in addition to mammograms. These include women who have:
However, not all women need annual breast MRIs. That’s because breast MRIs can sometimes find abnormalities that are not cancer–these are called false positives.
Research has shown women with average or low risk for breast cancer tend to have more false positives on their breast MRIs. False positives can lead to unnecessary biopsies and procedures as well as additional stress and worry.
If breast cancer is found on a mammogram, a breast MRI can give more information about the size of cancer, look for other cancers in the area, and help examine the other breast.
Radiologists can use an MRI to help guide them during a biopsy. By collecting multiple cross-section images, they can see exactly where to get the best tissue sample.
During the MRI, radiologists can also insert a tiny clip at the location of the biopsy. This clip is useful in case they need to return and surgically remove the tissue.
Advances in mammography have led to the development of 3D mammograms, also known as digital breast tomosynthesis or DBT.
While 3D mammography can benefit all women, it can especially help women with dense breasts. It can also help identify ductal carcinoma and other breast abnormalities.
3D mammographic screening, when combined with breast MRI, may improve early breast cancer detection rates over conventional mammography. As a result, that means earlier treatment and more treatment options if you develop breast cancer.
To learn more about mammograms, please check out:
