MR breast
Breast MRI provides a unique advantage over mammography and ultrasound. First of all, there is no ionizing radiation. Additional advantages include: better 3D spatial resolution, the ability to detect multifocal lesions, better ability to determine the actual size of the tumor (often underestimated in mammography and ultrasound), and the ability to image both the breast and chest wall including axillary lymph nodes.
The high quality of the examination is dictated by the fulfillment of the appropriate standards for the examination protocol, adherence to certain rules as well as standards. It is extremely important to determine the date of the examination, because it must be carried out between the 4th and 14th day of the menstrual cycle (this rule does not apply to postmenopausal women). Such action is dictated by the fact that the possible pathological change, which contrasts strongly against the background of healthy tissue, which in turn undergoes weak enhancement. The situation changes when the examination takes place at a different time as mentioned above. Then the image is loaded with less diagnostic value. Of course, at the time of suspicion of a proliferative process, time is of the essence, so the decision to conduct an MRI scan can be made despite the time inconsistency regarding the menstrual cycle. Another issue is the discontinuation of hormonal contraception, which can interfere with the image of the breast during the examination (then the timing of the examination is determined individually).
What are the indications for breast MRI?
- suspicion of a neoplastic process
- A loaded family history (mutation in the BRCA1/2 gene)
- Screening for women with BRCA1/2 gene mutation
- examination before breast surgery
- verification after mastectomy (evaluation of the effectiveness of treatment)
- breast check-ups
- Breast implants (check-ups, suspected implant rupture)
- Evaluation of efficacy with neoadjuvant chemotherapy
- many more…
Recently, the list of indications for breast MR has been growing. From a number of clinical aspects, it is considered important to perform breast MR especially in women with dense glandular tissue, in whom it is necessary to determine the progression of the disease before planning to proceed with treatment. Very often, thanks to the a.m. examination, it is possible to see changes that are not visible with mammography or ultrasound, and these are the examinations of choice.
What are the contraindications to breast MR?
Breast MRI cannot be performed in patients with permanently placed objects in the body such as:
- neurostimulator
- pacemaker
- insulin pump
- cochlear implant
- OLD TYPE implants, endoprostheses, stabilizers, plates and orthopedic screws, which are made of ferromagnetic materials. Current implants are used that can be in the strong electromagnetic field found in MR
- Shotgun shells, bullet fragments, metal filings in the eye
Other relative contraindications to MRI are: first trimester of pregnancy. In addition, the menstrual cycle, contraception taken as well as hormone therapy used should be taken into account.
Preparation for breast MRI:
- A current (no older than 2-week) creatinine level and eGFR should be provided,
- On the day of the test, remain fasting about 5 hours before the test,
- The test in menstruating women is performed during the menstrual cycle. If the patient is taking
preparations, the component of which is progesterone or estrogen (hormonal contraception, hormonal vaginal insert, HTZ) it is worth to stop them at least 6-8 weeks before the examination, if there are no other contraindications. - You should bring with you the results of all imaging tests that have been performed to date (mammography, ultrasound, biopsy results, previous MR scans, history from treatment).
Course of the study
Our facility has a state-of-the-art Siemens Magnetom Sola MR. Its software can digitally reduce motion artifacts, so the examination has much higher quality. Nevertheless, the patient should lie still. In addition, the machine is equipped with high-powered gradients, which makes the examination of the highest value. Breast MRI is completely painless and takes up to 45 minutes.