woman about to go into an mri machine talking to tech

Part 3 – Breast MRI

A subset of women, because of their genetics, breast structure, and/or family history, may want to take advantage of screening tools such as the 3D mammograms, MRI, and Automated Breast Ultrasound. This is why it’s best to work with your health care provider, giving them a thorough history, and the information they need, so that together you can choose the best screening plan for you.

When is a Breast MRI Needed?

I have patients who call and ask me to order an MRI of their breasts because a friend was just diagnosed with breast cancer (not necessary) and others with multiple risk factors who need one and have never been offered one. 

Magnetic resonance imaging (MRI) of the breast uses magnets and radio waves to produce detailed 3D images of breast tissue after a contrast dye is injected into a vein. A breast MRI is most often used for women at high risk for breast cancer after we use breast risk model, such as the Tyrer Cruzik or Gail model. Recently, researchers at Boston University developed a breast risk screening tool for Black women in the US

For women like me at high risk, MRI is recommended every 1-2 years. I have one every 2 years, but I have patients who need yearly MRI. 

The images can give radiologists and breast specialists a clearer picture of every layer of breast tissue. In addition, the images are not affected by dense tissue. If you are in the high-risk category due to a strong family history or known gene mutations, your provider may use this along with mammography. On the downside, studies have shown that breast MRI results in more false positives than mammography, which can lead to more biopsies being recommended. 

And again, a breast MRI is also more expensive, so as a provider, I often have to fill out a prior authorization form with the patient’s insurance company to get it covered. If an MRI is recommended, do check with your insurance provider to find the breast health center that’s in your network and has the lowest cost. 

Breast MRI also takes longer than a mammogram, around 45 minutes. If you take any medication to help you relax, you’ll need a ride to and from. In addition, the dye that needs to be injected can affect the kidneys of those with abnormal kidney function, which is why you’ll need to have some lab work ahead of time.

What to Expect with a Breast MRI

I’ve also had many breast MRIs and have found this video from MD Anderson Cancer Center helpful to show you what it’s like. I found that using deep mindful, meditative breathing helps me relax. 

Because this is done while you’re lying face down, the feeling of claustrophobia can be increased. If you’re at all claustrophobic, do talk to your provider about medications you might take beforehand to help stay relaxed. In addition, there is a very loud clicking noise, so earplugs and headphones with your choice of music is provided. 

As I read this over, one thing is very apparent. Women’s health is complicated! We deserve specialized care and recommendations from providers who are staying up to date with the latest research to provide personalized care that is tailored to a woman’s own unique medical and family history. 

Disclosure: I am not working with any of the companies mentioned in this blog. 

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