QUESTION: I have just been diagnosed with breast cancer; do I need a Breast MRI?
ANSWER: Breast MRI is a helpful imaging test when a patient has been diagnosed with breast cancer. The study images the breast in a different way than the mammogram or ultrasound. In some patients, it will find additional cancer in the affected breast. In about 5% of women, it will find a cancer in the opposite breast, which would not have been detected by the mammogram or clinical exam. Breast MRI is not perfect, however. It may detect an abnormality requiring additional testing, or perhaps even a biopsy of something that is not, in fact, cancer. It is very important to follow through with recommended testing/biopsy after an MRI exam shows a finding. It is not a good idea to assume that a finding is cancer, since it will not be cancer much of the time. Surgical planning should not be based on imaging alone.
Breast MRI is particularly useful for the following patients with a new diagnosis of breast cancer: young patients, those with dense breast parenchyma on mammogram, those with lobular-type breast cancer, and those with a family history (or a known genetic disposition to breast cancer).
Speak to your doctor to determine if you should undergo breast MRI before your cancer surgery.
Diagnostic breast MRI is performed after an injection of intravenous contrast (gadolidium, a different type of contrast than is used with CT scans or other X-ray exams). The patient is positioned on a special table, face down, with her breasts in special pockets or cups, and the table is placed within the magnet tunnel. No ionizing radiation is used to obtain the pictures. Most women tolerate the exam well, although some women with claustrophobia may benefit from anti-anxiety medication before the test.