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FAQs - Breast MRI
Who is a candidate for breast MRI?
What are the more common indications for breast MRI ?
If I have mammography and an MRI, will I get too much x-ray exposure?
How long does a breast MRI take?
Who interprets the breast MRI?
If the MRI is positive does that mean I have breast cancer?
What will happen if the radiologist sees something on the breast MRI?
Do I need a referral to make an appointment?
How do I make an appointment?
 
Who Is a Candidate for Breast MRI?
  • Newly diagnosed breast cancer patients. A breast MRI will provide more accurate information about tumor size and shape, allowing the surgeon to properly plan treatment. MRI will also help assure that there are no additional areas of cancer in the same breast or on the opposite side. Women contemplating lumpectomy often have anxiety about cancer being present in the remaining breast tissue. A breast MRI can provide the reassurance that the cancer is limited to one site. Also, in this era of “partial breast radiation,” the remaining breast tissue away from the lumpectomy site is not treated, so breast MRI is an excellent tool to help patients select this approach.
  • Patients with a past history of breast cancer. Women who have undergone lumpectomy and radiation often have scar tissue seen on mammography that can mask a recurrent cancer. Incorporating MRI into the follow-up plan vastly improves the chances of early detection. For women who have undergone mastectomy on one side, there is still a possibility of recurrence of the original tumor, plus the other breast is at increased risk for the development of a new primary breast cancer. Again, MRI is the most sensitive method of detection. Women who have already had bilateral mastectomies may still want to continue with MRI follow-up if they are at risk of local recurrence, especially if they have undergone a reconstruction that can interfere with early detection.
  • Diagnostic problems not settled by conventional imaging. Usually, breast concerns are completely evaluated through the use of mammography and ultrasound. However, if questions remain, breast MRI can offer great diagnostic assistance.
  • Implant status. Breast implants placed as part of cancer reconstruction are studied with MRI as part of routine follow-up. This is generally covered by insurance. When silicone implants are placed for cosmetic reasons, the FDA's new guidelines recommend breast MRI after 3 years, then every 2 years thereafter. Insurance coverage is less likely here (unless patients qualify for MRI based on other indications).
  • Asymptomatic screening. Yearly breast MRI, in addition to mammography, beginning at age 30 is now recommended by the ACS for women who:
    • Test positive for one of the BRCA genes, or a first-degree relative of a known BRCA mutation carrier,
    • Have a documented history of any of the rare genetic disorders in which breast cancer is one component,
    • Have a past history of being treated with chest irradiation for Hodgkin’s disease between ages 10 and 30, or
    • Have been calculated by any of the standard mathematical models to have a 20-25% (or greater) lifetime risk for the development of breast cancer.
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What Are the More Common Indications for Breast MRI ?
  • Breast cancer staging. Extent of disease evaluation prior to breast conservation surgery or mastectomy
  • Contralateral breast examination in patients with breast malignancy. MRI can detect unsuspected disease in the opposite breast in at least 4-5% of breast cancer patients—often with negative mammography and physical examination.
  • Lesion characterization. When conventional breast imaging studies such as mammography, ultrasound or physical examination are inconclusive for the presence of breast cancer
  • Monitoring chemotherapy treatment. To evaluate chemotherapeutic response and the extent of residual disease prior to surgical treatment
  • Evaluating patients with positive surgical margins for residual disease. To help determine which patients could be effectively treated by re-excision or whether a mastectomy is required due to the presence of more extensive disease.
  • Silicone and non-silicone breast implant evaluation. Evaluating breast implants for rupture and detecting cancer in women with breast implants
  • Evaluating post-operative scar versus tumor recurrence.
  • Occult breast cancer. Locating the very small, undiagnosed breast cancer (occult cancer) when a malignant axillary node is found and the origin cannot be determined with mammography or physical examination.
  • Surveillance of high risk patients. Breast cancer screening in patients with a genetic predisposition to breast cancer
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If I Have Mammography and an MRI, Will I Get Too Much X-ray Exposure?
Normal mammograms use x-rays to generate images of the breast tissue to search for cancer. MRI, on the other hand, uses no x-rays, but rather magnetic energy. Many breast abnormalities—including most, but not all breast cancers, are detectable with breast MRI. Abnormalities will concentrate a special non iodine contrast material allowing the radiologist to visualize and interpret these abnormalities using magnetic energy rather than x-ray energy.
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How Long Does a Breast MRI Take?
The entire study takes approximately 45 minutes. You will first have a series of images done. Then you will be given the contrast injection and the images will be repeated. The breast radiologist will then compare the images without contrast to the images with contrast.
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Who Interprets the Breast MRI?
A highly trained breast imaging technologist, under the direction of a dedicated board certified radiologist who only interprets breast MRI’s, mammograms and breast ultrasounds, performs the study. Other imaging centers may use technologists who take many different types of x-rays and scans.
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If the MRI Is Positive Does That Mean I Have Breast Cancer?
No. There are many benign conditions that will be seen on a breast MRI. The most common are some cysts, fibroadenomas and papillomas.
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What Will Happen If the Radiologist Sees Something on the Breast MRI?
If an abnormality is seen, the radiologist will characterize it as one that needs only a follow up MRI study in three to six months or as an abnormality that requires a biopsy. Needing a biopsy does not mean you have breast cancer.
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Do I Need a Referral to Make an Appointment?
Yes. Most policies do require a referral and a pre-certification. You should check with your insurance company. If pre-certification is required, tell us when you make an appointment and we will take care of it.
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How Do I Make an Appointment?
Call WIS at 425-688-0100 or fax us at 425-454-8911. We are open 5 days a week, Monday through Friday from 8 to 5. We normally are able to accommodate you within 48 hours.
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