Breast MRI

If you’re at high risk for breast cancer or received an unclear or suspicious test result, a breast MRI may be one of your best weapons for early detection and treatment.

While the number of breast MRIs performed each year is increasing, not all medical centers are the same. Many have imaging generalists on staff — technologists who perform a wide variety of MRI procedures.

Our physicians, technologists, and nurses have received specialized training in the field of breast imaging and are prepared to deliver exceptional care. In addition to clinical excellence, we also offer personalized, caring guidance and clear, direct answers.

What is Breast MRI?

Breast MRI is a diagnostic imaging procedure recommended for women who have a high risk for developing breast cancer (based on family history and other factors).

A breast MRI is more sensitive than a mammogram in detecting breast cancer. Breast MRI supplements the mammogram and/or ultrasound.

Because of its sensitivity, a breast MRI may result in additional imaging, a biopsy, or short-term follow-up MRI scan. For this reason, the procedure is reserved for women who are higher risk, or who may have an exam or mammogram with suspicious but inconclusive findings. For women in average risk groups, a mammogram is still the recommended screening tool for early detection. See all screening guidelines for breast cancer.

How Does a Breast MRI Work?

MRI (magnetic resonance imaging) technology uses a powerful magnetic field (not radiation) to “see” deep inside the body. The equipment takes three-dimensional pictures of the breast and its surrounding structures.

MRI has been used for many years to detect abnormalities or potential problems in many parts of the body. Since 2007, the American Cancer Society has recommended the use of breast MRI in evaluating women who are at high risk of developing cancer.

What to Expect During the Breast MRI Procedure

The breast MRI is an outpatient procedure that requires no fasting or anesthesia. The procedure itself only takes about 45 minutes, but we reserve one hour and 15 minutes so that you have time to check-in, change and talk with the technologist.

Preparation instructions may vary by physician and patient, but the following are the basic steps you’ll experience with the breast MRI:

Before the Procedure

  • A specially trained technologist performing the procedure will patiently explain each of the steps in the MRI and answer any questions you might have.
  • As with any medical exam or procedure, you’ll be asked about your medical history and any recent mammograms you may have had at another facility. (Be sure to bring that film with you.)
  • Some patients worry about feeling claustrophobic during the procedure—the technologist will help you manage those feelings and expectations. A light sedative can be given prior to the exam if needed. Please let your scheduler know.
  • You will need to remove any clothes above the waist and change into a hospital gown. You will also be asked to remove any jewelry, dentures, hearing aids, or other metal objects, such as belts, that could interfere with the magnetic technology.
  • An IV needle will be inserted into your hand or arm and a safe contrast agent called Gadolinium will be injected through the IV. The contrast material helps highlight any abnormal areas. Patients over age 65 will need blood work. (Let your technologist know if you have any kidney problems.)
  • You will then lie face down on an exam table with your breasts resting in a plastic, cup-shaped device — they are not compressed as in a mammogram. You’ll be able to see out from where your head is resting, if you choose to. Your arms will be resting over your head on the exam table.
  • The technologist will explain that you need to lie very still and breathe calmly and rhythmically so that the equipment can capture the best possible images. Movement can affect the quality and make it harder to identify suspicious areas.

During the Procedure

  • The exam table will move in and out of a closed, cylinder-shaped MRI machine, which will be taking images of your breasts. The first picture takes 30 seconds to complete. The machine will then continue taking pictures for a total of 45 minutes. You will be in the cylinder part of the machine during this entire time. Your breasts may feel slightly warm, but this is normal.
  • When you are inside the cylinder, you’ll hear some loud thumping and humming noises from the MRI machine. Before the procedure, the nurse or technologist may give you earplugs or music if you wish to reduce the noise.
  • The nurse or technologist will have explained the different sounds the equipment makes, and these sounds can help you gauge at what point you are in the procedure. The technologist will not be talking with you during the procedure. However, you will be given a squeeze ball to hold in case you have a serious need to stop the procedure and speak with the technologist.
  • When the exam is completed, you will be asked to remain in position to give the technologist a few minutes to check the images. In rare cases, we may need to take additional images.
  • After the images are checked, your IV line will be removed and you are free to get dressed and leave.

After the Procedure - Your Results

We understand the anxiety that can occur when you’re waiting to hear the outcome of a test. The results will typically be available within 24 to 48 hours. Some breast MRI patients have already been diagnosed with cancer and are undergoing the procedure as part of their surgery preparation. Your results will be discussed with you by your surgeon.

What is an MRI-Guided Breast Biopsy

An MRI-guided biopsy is an outpatient procedure in which images from the MRI are used to guide a needle or suction device to extract tissue samples from the breast.

An MRI biopsy takes less than an hour to complete and requires only a local anesthetic — most women report little or no pain or scarring.

Women usually undergo an MRI-guided biopsy when their breast MRI reveals a suspicious mass, an area of distortion, or abnormal tissue change. In this case, you may first undergo a targeted “second look” ultrasound or an additional mammogram. If the abnormality from the MRI is still not identified, your physician may recommend the MRI-guided needle biopsy.

What to Expect During an MRI-Guided Biopsy

  • As with the breast MRI, the specially trained technologist and nurse will talk with you before the procedure and answer any questions you might have.
  • You will prepare for the procedure in the same way that you would for the breast MRI. Even if you already had a breast MRI, you will need to have images scanned and checked again to guide the biopsy.
  • Once the precise area is identified for the biopsy, you will come out of the cylinder part of the machine. Your skin will be cleansed and you will receive a local anesthetic. You will feel a slight prick from the anesthetic and shortly after the area to be biopsied will become numb.
  • You will be asked to remain still and calm so that the biopsy needle can be positioned as accurately as possible.
  • A titanium marker clip is placed at the biopsy site.
  • Keep in mind that after the MRI biopsy you may experience some minor swelling or bruising. This is normal and temporary, and your physician may suggest an over-the-counter pain reliever or ice.
  • After the sample is taken, firm pressure will be applied to the area and a Steri-strip gauze dressing will be applied. There are no sutures or “stitches.”
  • A post-biopsy mammogram will be performed.
  • You should avoid anything strenuous for 24 hours, but after that you’ll be able to perform your normal activities.

After the MRI Biopsy Procedure - Your Results

You will return for a post-procedure check and results the next day. For questions regarding your breast biopsy, please call our breast center nurse at 847.535.6198.

Pre-certification for Breast MRI Procedures

Using MRI technology for breast evaluations is expensive — significantly higher than the costs of a mammogram. For this reason, Northwestern Medicine will ensure that you receive pre-certification from your insurance company before proceeding.

Please be aware that precertification does not guarantee payment in full for the procedure. Also, keep in mind that an order from your physician is required for a breast MRI.

We’ll do whatever we can to make sure you get the care you need as quickly as possible.