Breast MRI is a highly sensitive imaging modality used to detect malignancy within the breast.  It does not use radiation as in mammography, but radio frequency waves and magnetism. Two- and three-dimensional images are acquired and a contrast agent (gadolinium) is injected intravenously to help the radiologist to differentiate between benign and malignant tissue. Malignancies have more blood vessels than normal tissue and the gadolinium is taken up where there is increased blood flow. These areas will then enhance on the MRI images and with the help of specialised graphs the radiologist can then determine whether the enhanced area is a malignancy or not. 

Figure 1 demonstrates the anatomy of the breast MRI of the breast can be useful when: §         A woman has been diagnosed with breast cancer an MRI can help locate any additional, undetected tumours as well as define the extent of the cancer. §         Chemotherapy is used in large tumours and MRI can show whether the mass is shrinking prior to the surgery. §         MRI can assist in surgical planning where a patient is to have breast surgery and can help the surgeon decide whether a lumpectomy or mastectomy is needed. §         A woman has dense breasts (usually younger women) where interpretation using a mammogram can be difficult.   Breast MRI is routinely used for pre-operative staging in women with a known diagnosis of breast cancer.  It is also used to evaluate for residual disease or recurrence. MRI can also be helpful for monitoring response to neo-adjuvant chemotherapy, in surveillance for “high-risk” patients, and for patients with breast implants. High-risk patients can be patients with a family history of breast cancer or patients diagnosed with having one of the BRCA genes. Patient preparation required for Breast MRI §         Mammography films need to be available. §         Safety questionnaires filled in.   Breast MRI procedure You will be changed into a hospital gown and all jewellery and other metal will have to be removed. The procedure will be explained to you and safety questions will be asked. An intravenous cannula would be put into a vein (usually your arm) so we can give the contrast towards the end of the procedure without disturbing your position. You will be transferred onto the scan table that is wheeled inside the scanner, which looks like a round tube. You will lie prone and feet first on a special coil, which works like an antenna to make the images more clear.    §         The MRI machine is a large, tube-shaped machine that creates a strong magnetic field around you. This magnetic field, along with a radio frequency, alters the hydrogen atoms’ natural alignment in the body. §         Computers then form two-and three-dimensional images of your breasts as well as surrounding tissue based on the activity of the hydrogen atoms. Several cross-sectional images are obtained to reveal even more details. §         MRI does not use radiation, as do x rays or CT scans. §         Earmuffs or earplugs will be given for the noise and an alarm bell in case you want to speak to the radiographer during the procedure.  The machine produces loud thumping and humming noises during normal operation. There is an intercom system, but because it is so noisy we might not hear you while we are scanning. §         The whole procedure will take about 45 minutes. §         You’ll be asked to remain very still during the test. Results A set of films or a CD with the images will go back to your referrer. A radiologist will look at the scan and a report will be sent to you referrer as well as your GP.  Your doctor will talk to you about the results. After the procedure There are no after-effects from the study and you can eat and drink as normal.