An injected contrast agent – Gadolinium linked to a complex, biologically safe molecule (Gadolinium for short) – is used in this technique. The Gadolinium leaks from any new, tiny blood vessels. These occur in rapidly growing tissue, such as cancer. With this contrast-enhanced MRI, virtually all breast cancers enhance (that is, become brighter due to the leaked Gadolinium).
MRI is highly sensitive to the presence of cancer, so it has excellent potential to help patients when we are unsure of the diagnosis or if we have not been able to exclude or confirm the presence of cancer. Many of these enhancing lesions need to be further assessed by percutaneous biopsy.
Sometimes lesions cannot be detected by any other means than MRI, including examination by a breast surgeon, mammography, or ultrasound. In this situation, to biopsy the correct spot, it is necessary to perform the biopsy after being guided to that spot by a short repeat MRI study.
Breast MRI will often demonstrate the extent of breast cancer before surgery more accurately than other imaging techniques. Its use may minimise the need for repeated operations in some patients. MRI is a complementary investigation of breast problems. It does not replace clinical examination or other means of investigation such as mammography or breast ultrasound. The previous investigations and their results must be available to correlate with the findings of the MRI study. Please ensure that you bring previous examinations of the breasts to the MRI examination.
Uncommon types of surgery and electronic implants such as cardiac pacemakers may prevent you from having an MRI. The safety questionnaire we ask you to complete will allow us to check on these.
The overall time you will spend in the magnet will be up to 40 minutes. On occasion, we will need to perform an ultrasound after the MRI to clarify the MRI findings.
There is a lot of analysis involved in the MRI study, so the second look ultrasound will often be booked a minimum of two days following the MRI.
We use a special breast surface coil apparatus to image the breasts optimally. On our MRI scanner, this is a low padded plastic platform block with two holes in it, into which the breasts hang while you lie face down. So that the contrast agent can be injected in mid-scan without moving you, you will have a plastic cannula placed into a vein before we start. After being positioned comfortably, you will be moved into the magnet bore head first on a sliding table.
The MRI scanner bore is equipped with a microphone and speaker, so our MRI radiographers can talk to you during the examination and listen to your responses.
You will also be given a small alarm button which you can press at any time for assistance.
You will hear a banging noise expected in MRI scanning during the scan. You mustn’t move during the “loud” periods as movement spoils the images. After preliminary scans, you will be injected with a contrast agent into your vein. A set of scans will then be performed rapidly and repeated several times. A final set of scans will be conducted over a few minutes, and the procedure will then finish.
The information generated in this study is complex, and the analysis of the information will take some time so it will not be immediately available. The results will be sent to your doctor.
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