A breast MRI (Magnetic Resonance Imaging) is a diagnostic procedure that is used to detect abnormalities in the breast like breast cancer. This test makes use of magnetic fields and radio waves to produce clear and detailed computer-generated images of your breast tissues. These images are further examined by the healthcare team. Moreover, no radiation is used in MRI.

This procedure captures multiple pictures of your breast that are further combined with the help of a computer. A breast MRI may be recommended with mammography for the detection of breast cancer. It can also determine the extent of diseases including cancer tumors and benign (non-harmful) tumors in the breast. Sometimes, it is recommended during breast cancer treatment to examine the risk of disease progression.

Why is a Breast MRI done?

Your healthcare team will recommend a breast MRI if:

• You had a breast scan like a mammogram and are suspected to have breast cancer.
• You have a family history of cancer of the breast or ovary.
• You had strong radiation therapy treatment on your chest.
• Your breast possesses a gene change like BRCA1 and BRCA2.
• You have dense breast tissues as detected by a previous breast scan like mammography.
• You are suffering from breast cancer and the doctor wants to know the effects of chemotherapy medicines on the breast.
• You are suffering from breast cancer and the doctor wants to monitor the growth or shrinkage of tumors in the breast.
• You are suffering from breast cancer while receiving some drug like fulvestrant injection to examine cancer’s progression.

An MRI may also be recommended if you are experiencing any of the following symptoms:

• A newly inverted nipple
• A visible lump in the underarm
• A visible lump in the breast area
• Redness on or around the nipple
• Pain in the nipple
• Chronic pain in the breast
• Discharge from the nipple

Moreover, a breast MRI may be done for routine checkups and analysis of the breast tissues. This is common in women who have been suspected of having cancer recently or have a strong family history of cancer of the breast or reproductive organs.

How is a Breast MRI done?

Schedule your breast MRI in accordance with your period’s cycle if you are premenopausal. Tell your healthcare provider about the last menstrual cycle so that the procedure can be scheduled for the beginning of your next cycle. Furthermore, make your healthcare team aware of the following:

• Any pre-existing disease
• Any allergies you may have.
• Your chance of getting pregnant
• If you are nursing a child
• If you have kidney problems
• Any implanted medical devices in your body

Before the procedure

• If you already take breast cancer medicine, make sure to tell your doctor.
• Your radiologist will give you an intravenous injection containing gadolinium before the procedure starts. This is a dye that travels through your bloodstream and aids in providing clearer pictures. You will also experience a cool feeling at the site of the injection.
• To prevent discomfort caused by the loud sound of the MRI machine, you can carry your earplugs or earphones.
• If you are afraid of small or dark spaces, make your radiologist aware of the same. You may receive a sedative to stay calm during the procedure. A sedative is a drug that calms a person and induces sleep.
• Besides these, be sure to remove every metal object you are wearing including watches, jewelry, hairpins, etc.

During the procedure

• The whole procedure may take up to 90 minutes.
• Your radiologist will ask you to lie on your stomach with your face placed downwards on a specially designed padded table.
• Your arms must be on your side and your head on the headrest.
• Also, the padded table possesses two openings for your breasts in order to avoid squeezing.
• Once you are settled on the table, it slides inside the MRI machine slowly. The MRI machine is a tunnel-like (narrow) opening.
• Multiple images will be taken during a sequence. You may have to lie in the same position for about 2 to 6 sequences (as per the radiologist’s recommendation).
• Even being inside the machine, you will be able to contact your technician who is monitoring the procedure from a nearby room. Moreover, your technologist will give you relevant instructions during the test including when to hold your breath.
• While the pictures are being taken, you might feel an urge to urinate. Plus, your breasts may experience warmth inside the machine. This is completely normal.
• Once the images are produced, you will be taken out of the machine.

After the procedure

• If you have received a sedative before the MRI, make sure to not drive. Ask your friend or relative to drive you back home. You may need rest since sedatives can make you dizzy for some time
• If you have not received a sedative, you can get back to your daily routine right after the procedure, even driving.

Preparation of Results

The pictures obtained from MRI are viewed by the healthcare provider. In simple words, your healthcare provider will check the presence of the following:

• Non-cancerous growths: Cysts or lumps in your breast area and the armpits that are not harmful.
• Calcification: Hard cells or tissues in your breast due to calcium build-up.
• Cancerous growths: Cysts or lumps in your breast area and the armpits that indicate a gene abnormality (cancer).

Breast Imaging Reporting and Database System or BI-RADS is a pre-determined system of explaining the results of a breast MRI. There are 7 categories in total ranging from 0 to 6 wherein each category indicates a different result.

• Category 0: This category means that the MRI was not completely done. In such a case, another sequence of the test will be recommended by the healthcare provider.
• Category 1: This implies that the diagnostic procedure was completed and the results are healthy. In medical terms, Category 1 signifies the absence of cancer in the breast.
• Category 2: This category means that the results are healthy and normal. However, your healthcare provider may have examined lumps in your breasts that may not be harmful or cancerous.
• Category 3: The third category means that the result of the MRI is almost normal with a little probability of cancer. In such a case, your healthcare provider may recommend another MRI after 6 months approximately.
• Category 4: This implies that a suspicious cyst or lump (abnormality) is present. In such a situation, your healthcare provider will recommend a biopsy to diagnose precisely. Moreover, he will tell you about the chance of breast cancer (about 25% to 35%).
• Category 5: The fifth category of BI-RADS implies a high probability of breast cancer. In such a situation, there is at least a 95% chance of cancer. Your doctor will strictly recommend a biopsy for clear results.

Category 6: The sixth category is mentioned in the reports of patients who have undergone a breast MRI as an act of checking the progress of medications they are taking. Most often, the doctor recommends a breast MRI to breast cancer patients to see the shrinkage of tumors.

This is how you can read your MRI results easily. Furthermore, you may require other tests as per your doctor’s recommendation.

NOTE: Do not skip any medical appointments or others due to something you have read here.