The UW Health Breast Center, in Madison, Wis., offers breast MRI — one of the most advanced breast imaging tools available in medicine today. MRI uses magnetic fields and radio waves to create detailed images of the breasts.
Advantages of breast MRI
Breast MRI is an excellent test for finding breast cancer. If you are at elevated risk for breast cancer, your doctor may order a breast MRI in addition to a mammogram as a screening option. Breast MRI also can be used to look for additional cancer if you have been recently diagnosed with breast cancer or to evaluate response to treatment. However, MRI does not replace mammography, and most patients who have a breast MRI will have a mammogram as well.
How breast magnetic resonance imaging (MRI) is used
There are many reasons why your doctor may order a breast MRI. The most common reasons are:
Full breast MRI for elevated-risk screening
In addition to a mammogram, breast MRI is an excellent way to screen the breasts for cancer in patients at elevated risk. Things that may make a woman at elevated risk for breast cancer include a family history of breast cancer or a genetic mutation such as BRCA1 or BRCA2 (and several others). Many women with a personal history of treated breast cancer may also undergo breast MRI in addition to mammograms to screen for breast cancer, especially if they were younger than 50 years old when they were diagnosed or if they have dense breasts.
If you are uncertain if you are at elevated risk for developing breast cancer, the UW Health PATHS Clinic (Prevention, Assessment, and Tailored Health Screening) can help review your risk and determine if additional interventions or screening are recommended. Guidelines from organizations such as the National Comprehensive Cancer Network, American College of Radiology and American Cancer Society help providers decide which women will most likely benefit from breast MRI in addition to mammography to screen for breast cancer. Your provider can help you determine if you are at a higher risk for breast cancer and if a breast MRI would be a good additional test for you.
Full breast MRI for women with breast cancer
If you have been recently diagnosed with breast cancer, your provider may order a breast MRI to look for additional cancer in the same breast or a cancer in the opposite breast. Patients having therapy before surgery (neoadjuvant therapy) may have breast MRI to see if the cancer is changing in response to the therapy. Finally, patients with cancer in the lymph nodes under their armpit (axillary lymph nodes) may have a breast MRI to see if breast cancer can be found.
Other reasons to have a breast MRI include following up on a previous imaging study or biopsy.
Abbreviated breast MRI for women with dense breasts
Some women are not at higher risk for breast cancer because of their family history or other reasons, but they have dense breasts. Women with dense breasts have a slightly increased risk for breast cancer and it is more difficult to find breast cancer on their mammogram due to dense breast tissue. These women may choose to have an extra (supplemental) screening test in addition to mammography, and UW Health in Madison offers abbreviated breast MRI for these women. Abbreviated breast MRI is a shortened version of a breast MRI exam that studies have shown is a great additional test to find cancer in women with dense breasts.
Non-contrast breast MRI for women with silicone implants
If a woman has silicone breast implants, breast MRI is the best test to determine if the implants are ruptured.
Frequently asked questions
Does my breast MRI require IV contrast?
All breast MRI examinations looking for breast cancer require contrast, including abbreviated breast MRI exams. The only type of breast MRI exam that doesn’t need contrast is an MRI looking to see if silicone implants are ruptured, but this type of MRI does not look for breast cancer.
Who shouldn't have breast MRI?
If a patient cannot get IV contrast for an allergy or other reason, then breast MRI is not a good test to evaluate for breast cancer. Patients who are pregnant cannot have breast MRI. Patients need to be able to lay on their stomach for about 30 minutes and hold still to get a breast MRI.
Just like any type of MRI, you will need to answer some questions that ask if you have any metal in your body, such as cardiac pacemakers and defibrillators, brain aneurysm clips, prosthetic devices and other metallic implants. Although many of medical implants are safe to go into an MRI scanner, some are not or will decrease the quality of the breast MRI so that it is not a good test. The nurses, radiologists and MRI technologists involved in your care will help you answer these questions and decide if the MRI is safe and the correct test for you.
Does breast MRI replace mammograms?
Most women who receive breast MRI for screening for breast cancer will have mammograms for screening as well. This is because each test looks at the breast tissue in a different way and gives radiologists the best opportunity to find breast cancer. Breast MRI alone is not an option to replace regular screening mammograms.