MRIs Can Provide More Detailed Images Than Mammograms

Most women have their breast health checked with mammograms, but at times, an MRI may also be helpful.  

A breast MRI can offer more detailed images than a mammogram and is often used in women who already have been diagnosed with breast cancer be. Medical professionals often use the test to help measure the size of the cancer, look for other tumors in the breast, and to check for tumors in the opposite breast.

For certain women at a high risk for breast cancer, a screening MRI is recommended along with a yearly mammogram. Main Street Radiology offers Breast MRIs as part of routine screenings as well as to diagnose and facilitate the treatment of breast cancer. 

Case Study: A 30-year-old woman presented with a palpable abnormality in the right breast. Ultrasound showed an area of heterogeneous echogenicity (Figure 1). The mammogram showed dense breasts with a small area of microcalcifications (Figure 2). Biopsy showed carcinoma. The patient was then referred to Main Street Radiology for Breast MRI to determine the extent of cancer for surgical planning.

Findings: Post contrast axial and sagittal images (figures 3 and 4) demonstrate an area of intense early arterial phase enhancement (arrows) which corresponds to the sonographic finding. Although the mass is very posterior in location, there is preservation of the fat plane between the mass and the chest wall indicating the absence of chest wall invasion.

The patient underwent lumpectomy and was found to have a 2.5 cm invasive ductal carcinoma.

Discussion: A meta-analysis of 16 studies demonstrated the sensitivity of 95% and a specificity of 67% for Breast MRI (Hrung JM, Acad Radiol 1999:6:387-397), significantly higher than mammography or ultrasound.

At Main Street Radiology, the routine Breast MRI includes images of both breasts acquired simultaneously both before and at multiple time-points after the administration of IV contrast. Both the morphology as well as the dynamic enhancement characteristics of lesions are evaluated.

Rapid enhancement and de-enhancement is typical for malignancy (Type III curve on Figure 5). The rapid initial enhancement rate of malignancies is likely due to tumor angiogenesis. Malignant lesions are known to require the recruitment of a large concentration of tumor neo-vessels to permit their continued growth beyond a few millimeters.

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