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What to Know About Breast MRI - Advice from Expert Breast Imagers

The use of breast magnetic resonance imaging (MRI) has grown quite rapidly in the US. A powerful screening and diagnostic tool, breast MRI is used to detect abnormalities, stage tumors, and track treatment progress in those who have already been diagnosed with breast cancer.

But despite its many advantages, breast MRI is a new and unfamiliar testing method for the majority of patients. To better understand how the exam works and who can benefit from it, we spoke with four expert breast imaging radiologists. Here, they share their best advice on what patients should know about breast MRI.

Advice from a Radiologist

1. If you have dense breast tissue, a supplemental breast MRI can help ensure abnormalities are not missed.

by: Dr. Lisa Watanabe, Chief Medical Officer of CureMetrix

While mammograms are widely accepted as the baseline tool for early detection of breast cancer, for women with dense breast tissue, the accuracy of mammography can drop to as low as 50 percent. In a recently published study, researchers concluded that women with extremely dense breast tissue (Type D) may also not benefit from 3d mammography. This is because there may be cancers hidden within the dense tissue that appear obscured on mammogram images. If you have dense breast tissue, speak with your doctor about getting, a supplemental breast MRI scan or ultrasound (in addition to a mammogram) to help prevent any abnormalities from being missed.

2. Breast MRI plays an important role in patient management following a breast cancer diagnosis.

by: Dr. Vivian Lim, Breast Imaging Specialist at UC San Diego Health

While breast MRI is a great screening exam, it also plays a vital role in patient management after a tumor has been detected. When compared to ultrasonography and mammography, breast MRI is more accurate in determining the size of a breast cancer mass. This makes it a valuable tool for cancer staging. Another main use of breast MRI is to monitor presurgical response to treatment, such as chemotherapy.

3. Breast MRI can help ensure screening accuracy for high-risk patients.

by: Dr. Lisa Watanabe, Chief Medical Officer of CureMetrix

The breast cancer detection rate with breast MRI is much higher than with mammography or ultrasound. For this reason, breast MRI is a useful tool for screening high-risk patients who have a strong family history of breast cancer or other high-risk factors. If you're unsure of your risk, your doctor can help you determine where you stand.

With more and more patients getting referred for breast MRI scans, many facilities have started to offer abbreviated (shortened version) breast MRI exams as a cost-effective option.

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4. Be sure to schedule your breast MRI at the right stage of your menstrual cycle.

by: Dr. Nancy Forcier, Breast Imaging Specialist at Scripps Clinic

It’s extremely important for women to time their breast MRI exams at the appropriate stage of their menstrual cycle. If you get the exam at the wrong time of your cycle, there is a much greater risk of getting a false-positive.

For premenopausal women, the best timing for breast MRI is day 7-15 of the menstrual cycle. For postmenopausal women, breast MRI can be done at any time. When you schedule your appointment, discuss the timing with your provider to ensure you have the test done during the optimal window.

5. Get a second opinion on your breast MRI exam.

by: Dr. Vivian Lim, Breast Imaging Specialist at UC San Diego Health

Breast MRI produces very detailed images that require advanced skills to interpret. If the radiologist reading your scans is not familiar with these types of studies, there’s a much greater risk that something could be missed or inaccurately diagnosed. Getting a second opinion from a remote service, such as DocPanel, allows you to access top breast imaging subspecialists from anywhere in the world. You get your results in 24-72 hours and the cost is only $199. It’s a great way to ensure accuracy and get some peace of mind.

Even if your scans were initially reviewed by a specialist, a second opinion is especially recommended for those with dense breast tissue or individuals who are at high risk. If you have been diagnosed with breast cancer, a second opinion helps ensure the cancer is accurately identified (in terms of subtype) and staged. This will impact treatment planning.

READ NEXT: Patient Story Feature - How a Second Opinion Helped Diagnose My Breast Tumor

6. Choose your imaging center wisely.

by: Dr. Cindy Lee, Clinical Assistant Professor at NYU Langone Health

Make sure the radiology office that does your breast MRI also offers MRI guided biopsy. If they don’t offer MRI biopsy, it is likely they don’t do many breast MRI exams, which indicates less experience. It also means that you will likely need to go elsewhere for an MRI biopsy (should you need one). This makes the process more time-consuming - which can be a challenge for those with busy schedules. Additionally, some MRI images do not transfer well to a different office - so you run the risk of diminishing image quality. And, lastly, many insurance companies will not pay for a repeat MRI.

7. Talk with your doctor about whether or not breast MRI is right for you.

by: Dr. Nancy Forcier, former Breast Imaging Specialist at Scripps Clinic

Many patients are now requesting a breast MRI because they’re anxious about their mammograms missing something. However, while a breast MRI can undoubtedly be helpful in some instances, it‘s not beneficial for everyone.

There are specific indications for breast MRI. It is not recommended as a routine screening modality for breast cancer in all women. It is very sensitive, but not all findings will be cancer. Many times a biopsy will be needed to confirm a benign or malignant process and these additional biopsies can create unnecessary anxiety. Therefore, it is important to discuss the potential benefits of breast MRI with your physician. You will most likely also need a mammogram and ultrasound before this.

Breast MRI Quick Facts

What is breast MRI?

A breast MRI (magnetic resonance imaging) scan is a type of imaging test that uses magnetic fields and radio waves to check for abnormalities in breast tissue. Breast MRI can be used as both a screening and a diagnostic tool - to detect abnormalities and to further evaluate them.

Should I get a breast MRI scan instead of a mammogram?

While mammography may not be as effective in certain cases, a breast MRI should not be used in place of a mammogram, but rather in addition to one.

Does a breast MRI use radiation?

No, breast MRI does not use radiation.

Do you work at an imaging facility? DocPanel provides post-processing software for breast MRI exams, including parametric curves, color maps, and other advanced analytics. Facilities don't have to purchase licenses for this software and also benefit from expert reads by breast imaging MQSA certified subspecialized radiologists. If you would like more information, send us a note here and a team member will reach out to you.

In this article...

1. If you have dense breast tissue, a supplemental breast MRI can help ensure abnormalities are not missed. 2. Breast MRI plays an important role in patient management following a breast cancer diagnosis. 3. Breast MRI can help ensure screening accuracy for high-risk patients. 4. Be sure to schedule your breast MRI at the right stage of your menstrual cycle. 5. Get a second opinion on your breast MRI exam. 6. Choose your imaging center wisely. 7. Talk with your doctor about whether or not breast MRI is right for you. Breast MRI Quick Facts What is breast MRI? Should I get a breast MRI scan instead of a mammogram? Does a breast MRI use radiation?

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