Screening and Diagnosis How do radiologists perform a breast MRI? Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create a composite, 3-D image of your breast. A breast MRI is much more complicated to perform than a mammogram. That's one reason why your insurance may not cover the test, unless you are high-risk or your doctor has requested that it be done to further explore something suspicious seen on a mammogram.
Many centers now offer breast MRI. If you live in or near a large city, you may have a breast care center near you that offers MRI-guided biopsy. These centers are able to do both an MRI and the MRI-guided biopsy that is done if something suspicious is seen on the MRI. (This is typically done as two appointments.) If you live in a smaller city or in a more rural area, you may not have a center close to you that offers MRI-guided biopsy. That's okay. You can have the MRI performed at the center nearest you; then, if you need to have an MRI-guided biopsy, you can travel to the closest facility.
You should plan on the MRI taking at least an hour, if not longer. You should tell the MRI center if you're premenopausal, as many facilities prefer to schedule a premenopausal woman's MRI during days seven to 14 of her menstrual cycle. (Due to fluctuation in hormones, this is often the best time to have an MRI. You should also tell the MRI center if you have a cardiac pacemaker or other electronic device implanted in your body or if you're pregnant or think you may be pregnant. (MRI generally isn't recommended in these circumstances.)
Because MRI uses magnetic fields to create an image of the breast, you will need to remove any metal you are wearing, such as hearing aids, dentures, jewelry, watches, and hairpins, which might be attracted to the magnetic field the MRI creates. You will probably be wearing a cloth or paper covering, but if you are allowed to keep your pants on, be sure to remove any coins or credit cards from your pockets, as they, too, can be attracted to the magnet. In addition, the magnet could erase information encoded on scanner strips on your credit or ID cards.
Before going into the MRI machine, a nurse will put a small catheter into your arm. Once the procedure gets underway, the nurse will inject gadolinium—a contrast agent that allows abnormalities in the breast to be seen on the MRI—into the catheter. You will then be asked to lie still for about an hour while the scanner creates its image. This can be difficult to do, but it's necessary for the picture to be clear.
The MRI machine has a large, round opening; it looks like a big tube. You will be asked to lie on your stomach on a padded table. Your breasts will fit into a hollow area of the table that contains coils that detect the magnetic signals that create the breast images. Once you have been positioned properly, the radiologist will move the entire table into the opening of the machine. This can be hard for people who have trouble being in a small, confined space. To remedy this, many doctors will have their patients take a mild sedative, like lorazepam (brand name Ativan), 30 minutes to an hour before the MRI. If you have a sedative, you will not be able to drive after the MRI, so be sure to bring along a friend or family member who can assist you.)
When the MRI machine is turned on, it creates a magnetic field around you, and radio waves are directed at your body. There aren't any known harmful effects from exposure to the magnetic fields or radio waves. You may hear loud tapping or thumping sounds while you are in the MRI machine. Some facilities give you earplugs or headphones with music to reduce the noise. (If you have a sedative, these noises will probably be less bothersome.)
As noted previously, insurance companies don't always cover MRI, and they are expensive—$1,000 or more. Before having a breast MRI, always check with your insurance company to see whether you'll be covered.
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