Breast MRI in High-Risk Cancer Patients: Role, Procedure and Benefits

Breast cancer is a common cancer in women, and early detection is of great value in treating the disease. Mammography is an important breast cancer screening exam, but there are also certain women with a greater-than-normal risk of breast cancer who require other imaging tests. Breast MRI is a modern imaging system that employs strong magnets and radio waves to form images of the breast tissue. 

Women who are at very high risk for breast cancer should also have breast MRI tests in addition to their usual mammograms to help detect abnormal changes early. Molecular Diagnostics and Therapy provides advanced diagnostic imaging services, including MRI examinations, based on the clinical requirements of patients and recommendations from their healthcare professionals.

What Is a Breast MRI?

Breast MRI is the magnetic resonance imaging (MRI) of the breast, which is a non-invasive imaging exam that makes detailed images of breast tissue. Unlike X-rays and CT scans, MRI is a non-radiating scan. Instead, it employs a powerful magnetic field, radio waves, and computer processing.

Doctors perform a breast MRI screening or breast cancer evaluation, typically using a gadolinium-based contrast agent, which is injected into a vein. The difference makes it easier to see abnormal breast tissue and allows for the easier detection of certain cancers. Breast MRI is not a substitute for mammography. It is typically ordered as a supplemental imaging study when there is a certain clinical indication, or when a woman's risk of developing breast cancer is unusually high.

Who May Need a Breast MRI?

For women at high risk for breast cancer, breast magnetic resonance imaging (MRI) is beneficial. In some women at high risk for breast cancer (estimated risk of around 20%–25% or more), breast MRI is recommended in addition to mammography and is performed annually. This includes women who have certain inherited genes or a family history of breast cancer.

Other cancer risk factors, such as radiation therapy to the chest at a young age or specific cancer hereditary syndromes, also warrant high-risk screening. A person's decision to get a breast MRI depends upon her overall risk, personal and family medical history, and screening recommendations from a health care professional.

Why Is Breast MRI Important for High-Risk Patients?

Women at high-risk have a higher likelihood of getting breast cancer at some time in their lives. An early diagnosis gives greater opportunity for appropriate treatment in time. Among the benefits of breast MRI is the fact that it can discover some breast cancers that cannot be identified on mammography or ultrasound. 

In addition, MRI is not contraindicated for pregnant women or patients with metal implants, and it also helps to acquire detailed information on soft tissues and does not use X-rays, gamma rays, or alpha particles. But breast MRI often also identifies regions that look suspicious but turn out to be harmless. This results in more imaging or biopsies. Thus, it is important to be screened by MRI if medically appropriate and to be read by trained breast imagers.

Breast MRI Benefits

Breast MRI offers several potential benefits, particularly for selected high-risk patients.

Detailed Breast Imaging

Women who are at a higher risk for breast cancer are offered extra screenings.

Additional Screening for High-Risk Women

MRI is an addition to annual mammography and enhances the screening effort for women at a considerably elevated risk of developing breast cancer.

No Ionizing Radiation

MRI does not use X-rays and therefore does not expose patients to ionizing radiation.

Evaluation of Suspicious Findings

Breast MRI is suggested if the mammogram, ultrasound, physical exam, or other test results indicate that additional tests are necessary.

Assessment of Known Breast Cancer

For women with previously diagnosed breast cancer, MRI is used to help determine the extent or location of disease and/or to assess the opposite breast, when clinically indicated.

How Is a Breast MRI Procedure Performed?

Breast MRI is typically done in an outpatient setting. The patient is instructed on attire prior to the scan and to remove potentially interfering articles of metal (jewelry, watches, hair accessories, etc.) before the scanning session. A brief IV is inserted in the arm (or hand) for a breast MRI in which contrast dye is administered. The patient is then placed face down on a particular magnetic resonance imaging (MRI) bed. Breasts lie in a special cut-out in the table and are not compressed for imaging.

The table gently comes into the MRI scanner. The patient must be as still as possible as they are being examined. The scanner makes loud tapping/humming noises; earplugs or earphones are available if necessary. If it is needed for contrast, it is injected during the examination. The whole process of breast MRI typically takes about 20 to 30 minutes, and may take longer if there is a need for further imaging study.

Preparation for Breast MRI

Preparation requirements may vary between imaging centres and according to the reason for the examination. Patients should inform the radiologist or MRI technologist about any medical implants, previous surgeries, kidney problems, allergies, medications, or the possibility of pregnancy. Certain implanted devices or metallic objects may require additional safety assessment before MRI.

If contrast is planned, the healthcare team may ask about previous reactions to contrast material and kidney function. Women who are pregnant or may be pregnant should inform their healthcare provider before undergoing the examination. Gadolinium contrast is generally avoided during pregnancy unless there is a strong medical reason to use it.

Conclusion

Breast MRI is a cutting-edge diagnostic tool that is a valuable component of breast cancer screening and evaluation, especially for high-risk women. Uses in detail-desk images of the breast without ionizing radiation and can detect some abnormalities that cannot be seen on mammography or ultrasound. Women who have a high risk of developing breast cancer need an annual breast MRI, in addition to yearly mammograms. But MRI is not appropriate for everyone and sometimes yields false positive results which need to be further investigated.

Discuss your screening options if you have a breast cancer history of family members, or you have known risk factors for breast cancer (genetic risk or chest radiation). Advanced MRI and diagnostic imaging services, based on each patient's clinical needs, are provided at Molecular Diagnostics and Therapy.