Breast MRI: The Role of Advanced Technology in Detection of Breast Cancer
By Marcy Rushford
You may be asking what the big deal is about Breast MRI? Isn’t mammography or ultrasound enough?
For some patients, the answer is yes, mammography is enough. Mammography is still considered the “gold standard” to screen for breast cancer. That means it is the best method we have to find breast cancer, often finding cancers years before they can be felt. But mammography is not foolproof.
So your doctor may recommend an ultrasound. Often, ultrasound is used as an adjunct to help characterize areas of concern that are identified on a mammogram or to look further at an area that is not seen as well as the physician might want. On rare occasion, cancers are found on ultrasound but not on mammography, or vice versa. Then, of course, there are those women for whom mammography or ultrasound do not provide adequate information. They may be too young to have a mammogram or have very dense breast tissue or maybe a strong family history of breast cancer. They may have already been diagnosed with breast cancer. For these women, breast MRI can be an invaluable tool.
Breast MRI is also used as an adjunct; it does not replace mammography. MRI cannot detect abnormalities like breast calcifications, which can be a sign of breast cancer, while mammography can. Breast MRI, like ultrasound, is used to further evaluate areas that are difficult to see on a mammogram. Mammography compresses breast tissue, so sometimes normal structures can overlap to look more concerning—this problem is eliminated when an MRI is performed. Doctors can use the information obtained through this imaging to determine if a biopsy should be performed, or if the area of concern is stable. Used in conjunction with mammography and breast ultrasound, MRI is highly diagnostic for breast cancer.
For those patients with breast cancer, breast MRI is a very important imaging test. It is used to help stage a cancer so doctors can better plan treatment and can determine if a cancer has spread through the muscle or identify large lymph nodes that may be indicative that the cancer has spread. It also, in some instances, may identify a second cancer in the same or opposite breast that might not have been visible yet on other types of imaging. For those patients who have had surgery, breast MRI is used to evaluate those areas where there is scarring in the breast to determine if the cancer has recurred.
Some other things to know about breast MRI:
- Images are obtained using a very powerful magnet. If you are referred for a breast MRI, the technologists will thoroughly screen you to ensure it is a safe test for you to undergo.
- Breast MRI is interpreted by a board certified radiologist. He will compare your MRI to your mammogram and/or ultrasound and review your medical history. Because there are many images obtained for a breast MRI, it may take up to 48 hours for a final interpretation to be made. Your results will go to your doctor after this thorough review is done.
- Your doctor may recommend an MRI if your mammogram or ultrasound is not definitive (if you have very dense breast tissue that might hide a cancer), if you or a family member carry a BRCA 1 or 2 gene, if you carry a lifetime risk of 20% or more of getting breast cancer (high risk), or if you have been diagnosed or have been treated for breast cancer.
- Breast MRI and genetics testing should not be considered a replacement for annual mammographic screening, as recommended by both the American College of Radiology and the American College of Obstetricians and Gynecologists, but rather as an adjunct for further evaluation of an abnormality, or to assess personal or family risk factors that might better determine what testing pathways are appropriate for each individual. Mammographic screening is recommended for all women annually from age 40.
The Breast Care Program at BMH is a collaborative group of professionals including staff from Imaging, Nursing, Oncology, Pathology and Surgery, among others. This unique collaboration, which utilizes a nurse navigator to coordinate and ‘guide’ a patient through their pathway of care, ensures that patients referred to evaluate for or who have a diagnosis of breast cancer can be assured their visit and plan of care is individualized with an intent toward the best possible outcome. The Diagnostic Imaging department is proud to be part of this program.
Marcy Rushford, CRA, MBA, RDMS, RT(R,M) is the Director of the Radiology and Cardiology Unit at Brattleboro Memorial Hospital. She is one of less than 700 radiology administrators in the U.S. to have passed the Certified Radiology Administrator (CRA) exam, which measures skills and expertise in medical imaging management.