New Technology
MRI of the Breast
MRI Approaches 100% Sensitivity Detecting Invasive Carcinoma of the Breast.
Indications
Integrity of Breast Implants: The modality of choice for this indication.
Invasive Lobular Carcinoma: Tumor margins are frequently indistinct on physical exam, mammography, and
ultrasound and best demonstrated on MRI. Management is changed in 50%.
Staging of Invasive Carcinoma: Detection of multi-centric or multi-focal involvement is critical for
treatment planning. Axillary, internal mammary and distant metastases to the bony thorax and liver can be identified.
See also PET (positron emission tomography) and Breast
Cancer.
Occult Breast Cancer: About 0.3% of breast cancer presents with axillary metastases and negative physical
exam and mammogram. MRI detects about 2/3 of the primary tumors, which allows for lumpectomy and radiation rather
than mastectomy.
Close or Positive Margins: Positive margins are found in up to 50% of resections for primary breast
cancer. MRI can demonstrate the extent of residual tumor.
Post-Op Scar Vs. Recurrence: After the initial scar matures (6 to 18 months), tumor recurrence can accurately
be distinguished from scar.
Neo-Adjuvant Chemotherapy Response: The initial size of the tumor and response to various chemotherapies
is well demonstrated.
Very High Risk Screening: Those patients who are documented carriers of BRCA1 and BRCA2 genes, or who
have received mantle irradiation for Hodgkin's Disease, are at very high risk of developing breast cancer
in their lifetime.
Overview
MRI is the most sensitive imaging modality available at this time for detecting invasive carcinoma of the breast.
Its sensitivity is less for DCIS (30 to 70%) especially with low and intermediate grade tumors. Its specificity
is 30 to 60%.
In pre-menopausal women, specificity varies with the phase of the menstrual cycle (lowest in the luteal phase).
In postmenopausal women, specificity is reduced in those on post menopausal hormones. It is not a replacement
for mammography, ultrasound and physical examination of the breast.
What patients need to know
MRI of the breast is not a substitute for mammogram, ultrasound and physical examination of the breast but
may be indicated in several circumstances. It is the imaging test of choice in evaluation implants for possible
leakage or rupture. It can be useful in treatment planning in select patients who have been diagnosed with breast
cancer. For women considered at high risk for breast cancer, it is much more accurate than mammography and/or
breast ultrasound in detecting potential sites of cancer in the breast, particularly for women with "dense"
breasts.
MRI of the breast is safe and poses no risk to patients if safety guidelines are followed. As with any MRI
exam, patients with any of the following conditions must notify the scheduler:
- Heart pacemaker
- Pregnancy or suspected pregnancy
- Cerebral aneurysm clip
- Implanted insulin pump, narcotics pump, or implanted nerve stimulators
- Metal in the eye or eye socket
- Cochlear (ear) implant
- Implanted spine stabilization rods
- Severe lung disease
- Gastroesophageal reflux
- Claustrophobia
- Weigh more than 300 pounds
Imaging technology
- 1.5 tesla, GE LX Short-bore Hi speed plus MRI
- Dedicated Bilateral Phase Array Breast Coil
Available at
| |
| Scheduling and clinic |
(253) 761-4200 |
Scheduling fax |
(253) 761-4201 |
| Medical records fax |
(253) 284-0622 |
|
TRA Physicians
|
Indications
