Lesion characterizationBreast MRI may be indicated when other imaging examinations, such as ultrasound, mammography and physical examination are inconclusive for the presence of breast cancer.

Local staging of breast cancerIn patients with biopsy- proven malignancy, breast MRI is used to determine extent of disease (multifocality and multicentricity) in the ipsi-lateral breast and to screen for disease in the asymptomatic contra-lateral breast.

Neoadjuvant chemotherapyMRI is used before and during the course of chemotherapy to evaluate chemotherapeutic response and extent of residual disease prior to surgical treatment.

Post-lumpectomy bed evaluation/scar vs. recurrenceMRI is applied in patients with prior lumpectomy and questionable recurrence within the lumpectomy bed on mammography and ultrasound.

Positive margins post lumpectomyMRI is used to assess the extent of residual disease in patients with close or positive margins post-lumpectomy. MRI can help determine if re-excision or mastectomy will be necessary.

Chest wall invasionMRI is indicated for the evaluation of chest wall involvement prior to lumpectomy or mastectomy.

Occult primaryIn patients presenting with axillary lymphadenopathy and no mammographic evidence of malignancy, MRI is utilized to assess for an occult primary.

Palpable lumpIn patients with a palpable lump and a negative diagnostic evaluation on mammography and sonography, MRI may be useful to exclude an underlying abnormality.

Problem-solving/difficult mammogramMRI may be used as a problem-solving tool in the situation of a difficult mammogram.

Screening of high-risk patientsScreening MRI is now recommended by the ACS for women with an approximate 20 percent to 25 percent or greater lifetime risk of breast cancer, including women with a strong family history of breast or ovarian cancer and women treated for Hodgkin's disease.

Implant integrityNon-contrasted MRI using silicone-sensitive sequences is used to assess implant integrity (intra- and extra-capsular implant rupture).

MedicationsIt is important for you to keep to your regular medication schedule. Just let our staff know what medications you have taken prior to your MRI Exam.

Food and drinkYou may eat or drink before a breast MRI test.

What to wearYou will change into a hospital gown. There is a secure locker for your clothes. If you are wearing anything metallic, such as jewelry, dentures, eyeglasses, or hearing aids that might interfere with the MRI scan, we will ask you to remove them. Credit cards, electronic devices, watches, and other metallic objects will not be permitted in the MRI scan room.

Intravenous preparationMany of our patients receive a contrast agent intravenously (IV - in a vein in the arm) during their MRI scan in order to give a clearer picture of the area being scanned. If your doctor has determined that this procedure will enhance your MRI scan results, the technologist will place an IV in your arm.

The breast MRI should be scheduled between day 5 and 15 of your menstruation cycle. A prescription from a physician is required for an MRI exam. You may need a referral from your physician or pre-authorization from your insurance company. Call our office for details.

The patient will need to lie very still as images are taken. About halfway through the exam, you will receive a painless injection and then more images are taken.

If you are claustrophobic or anxious about your MRI exam, don't worry. We can provide you with medication that will make you very comfortable during the exam. However, you will need someone to drive you home.

MR imaging of the body is performed to evaluate:
organs of the chest and abdomen—including the heart, liver, biliary tract, kidneys, spleen, bowel, pancreas and adrenal; glands; pelvic organs including the reproductive organs in the male (prostate and testicles) and the female (uterus, cervix and ovaries); blood vessels (MR Angiography); breasts.

Physicians use the MR examination to help diagnose or monitor treatment for conditions such as:
tumors of the chest, abdomen or pelvis; certain types of heart problems; blockages or enlargements of blood vessels, including the aorta, renal arteries, and arteries in the legs; diseases of the liver, such as cirrhosis, and that of other abdominal organs, including the bile ducts, gallbladder, and pancreatic ducts; diseases of the small intestine, colon, and rectum; cysts and solid tumors in the kidneys and other parts of the urinary tract; tumors and other abnormalities of the reproductive organs (e.g., uterus, ovaries, testicles, prostate); causes of pelvic pain in women, such as fibroids, endometriosis and adenomyosis; breast cancer and implants.

You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary with the specific exam and also with the facility. For some types of exams, you will be asked to fast for 8-12 hours. Unless you are told otherwise, you may follow your regular daily routine and take medications as usual. Some MRI examinations may require the patient to swallow contrast material or receive an injection of contrast into the bloodstream. The radiologist or technologist may ask if you have allergies of any kind, such as allergy to iodine or x-ray contrast material, drugs, food, the environment, or asthma. However, the contrast material used for an MRI exam, called gadolinium, does not contain iodine and is less ikely to cause side effects or an allergic reaction. The radiologist should also know if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease may prevent you from being given contrast material for an MRI. If there is a history of kidney disease, it may be necessary to perform a blood test to determine whether the kidneys are functioning adequately.

Women should always inform their physician or technologist if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980's with no reports of any ill effects on pregnant women or their babies. However, because the baby will be in a strong magnetic field, pregnant women should not have this exam unless the potential benefit from the MRI is assumed to outweigh the potential risks. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative prior to the scheduled examination.

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area unless explicitly instructed to do so by a radiologist or technologist who is aware of the presence of any of the following: internal (implanted) defibrillator or pacemaker; cochlear (ear) implant; some types of clips used on brain aneurysms.

You should tell the technologist if you have medical or electronic devices in your body, because they may interfere with the exam or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Examples include but are not limited to: artificial heart valves, implanted drug infusion ports, implanted electronic device, including a cardiac pacemaker, artificial limbs or metallic joint prostheses, implanted nerve stimulators, metal pins, screws, plates, stents or surgical staples.

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect the presence of and identify any metal objects.

Patients who might have metal objects in certain parts of their bodies may also require an x-ray prior to an MRI. You should notify the technologist or radiologist of any shrapnel, bullets, or other pieces of metal which may be present in your body due to accidents. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem. Tooth fillings and braces usually are not affected by the magnetic field but they may distort images of the facial area or brain, so the radiologist should be aware of them.

Most MRI exams are painless, however, some patients find it uncomfortable to remain still during MR imaging. Others experience a sense of being closed-in (claustrophobia). Therefore, sedation can be arranged for those patients who anticipate anxiety, but fewer than one in 20 require it. It is normal for the area of your body being imaged to feel slightly warm, but if it bothers you, notify the radiologist or technologist. It is important that you remain perfectly still while the images are being recorded, which is typically only a few seconds to a few minutes at a time. For some types of exams, you may be asked to hold your breath. You will know when images are being recorded because you will hear tapping or thumping sounds when the coils that generate the radiofrequency pulses are activated. You will be able to relax between imaging sequences, but will be asked to maintain your position as much as possible. You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centers allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment. When the contrast material is injected, it is normal to feel coolness and a flushing sensation for a minute or two. The intravenous needle may cause you some discomfort when it is inserted and once it is removed, you may experience some bruising. There is also a very small chance of irritation of your skin at the site of the IV tube insertion. If you have not been sedated, no recovery period is necessary. You may resume your usual activities and normal diet immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local pain. Very rarely, patients are allergic to the contrast material and experience hives, itchy eyes or other reactions. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.