Breast MRI:what to expect

Your doctor may recommend a Breast MRI to look closely at your breasts, especially if you:

• Have a high lifetime risk of breast cancer (due to a strong family history or BRCA gene mutations).
• Have a newly diagnosed breast cancer, and the doctor needs to determine the exact size and extent of the tumor prior to surgery.
• Are undergoing chemotherapy, to measure how well the tumor is shrinking.
• Need to check if silicone breast implants have ruptured or leaked.
• Have inconclusive results from a mammogram or ultrasound.

A Breast MRI helps doctors visualize:

• The breast tissue, lymph nodes in the armpit, and the chest wall muscle.

It is particularly useful for identifying:

• Small tumors that may be hidden by dense breast tissue on a standard mammogram.
• Cancer that has spread to the lymph nodes or chest wall.
• Ruptured or leaking silicone breast implants.

If you are being screened for cancer or evaluating a lump, yes. A contrast dye called gadolinium will be injected through an IV in your arm. Cancerous tumors grow extra blood vessels, and the contrast dye makes these abnormal areas "light up" brightly on the MRI.

Note: If the MRI is strictly to check for a ruptured breast implant, contrast dye is generally not required.

Normal breast tissue is very sensitive to hormonal fluctuations. During certain times of the month, normal, healthy breast tissue can temporarily swell and "light up" when contrast dye is used. If the scan is done at the wrong time, these normal hormonal changes can mimic the appearance of a tumor, leading to a "false positive" result and unnecessary anxiety. Scheduling the scan between days 7 and 14 of your cycle ensures the breast tissue is hormonally quiet.

Yes, the timing of your scan is very important.

• If you are premenopausal (still having regular periods), you must schedule the MRI between days 7 and 14 of your menstrual cycle.
• Remove all jewelry, metal objects, and clothing with zippers, and change into a hospital gown.
• Tell your doctor if you have claustrophobia or any metallic implants, such as a pacemaker.

The scan is painless. Unlike a mammogram, there is no hard compression or squeezing of your breasts.

You will lie face down (prone) on a specially designed padded table. The table has two hollow openings, and your breasts will hang down freely into a receiving device called a "breast coil". Lying face down helps separate the breast tissue from the chest wall for clearer images.

The machine is loud, so you will wear earplugs or headphones. It is critical that you remain completely still during the scan.

The scan usually takes between 30 and 45 minutes.

After the scan, a specialized Breast Radiologist will carefully review the images and prepare a report. Results are usually available within a few days, and your doctor will discuss whether any further testing or biopsies are needed.

MRI is generally safe as it avoids radiation. However, pregnant women should consult their doctor before undergoing a Breast MRI, especially because the contrast dye is typically not recommended during pregnancy.

• RadiologyInfo: Breast MRI
• ACR Manual on Contrast Media
• FDA: Gadolinium retention safety communication

A Breast MRI is a safe, incredibly detailed tool for evaluating breast health. While it does not replace routine mammograms, its exceptional sensitivity makes it an invaluable test for high-risk screening, surgical planning, and ensuring peace of mind regarding your breast health.