MRI Breast Biopsy

MRI Breast Biopsy

Magnetic resonance imaging (MRI) of the breast uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the breast. It is primarily used as a supplemental tool to breast screening with mammography or ultrasound in patients’ who have a high risk of developing breast cancer particularly in younger patients‘ with dense breast tissue. Further indications include evaluating the extent of cancer following diagnosis within the affected breast as well as the opposite breast to guide and plan further management by your specialists. Monitor treatment (neoadjuvant) response prior to planned surgery implant assessment.

Overview
The site of abnormality detected on your MRI breast examination is targeted for biopsy. The area of concern is accurately localised with a computer software program and grid system. A biopsy guide kit and needle is sited within the breast and a tissue sample is extracted during the biopsy. This tissue sample is sent to the pathology laboratory where the histopathologist analyses the tissue sample and reports on the results. The pathology report is then reviewed by your doctor and discussed with you.

  • Breast MRI should be performed at units capable of doing MRI-guided biopsy and localisation.
  • Breast cancer susceptibility gene (BRCA) mutations (including being a first-degree relative of a person with known BRCA mutation)
  • Other genetic disorders
  • Chest radiation for lymphoma
  • >20% lifetime risk

The following factors contribute towards the risk of developing breast cancer

  • Family
    • First-degree relatives are most important although some models also look at other relatives.
    • Number of relatives and age at diagnosis
    • Ashkenazi or Afrikanans heritage
  • Previous biopsy where a high-risk lesion was found, for example, atypical ductal hyperplasia (ADH) and lobular carcinoma is situ (LCIS)
  • Nulliparity
  • Dense breast Tissue
  • Early menarche or late menopause
  • Hormone replacement therapy
  • Obesity
  • Personal history of breast cancer

Absolute indications

  • High-risk screening
  • Occult breast cancer

Relative indications

  • Equivocal results on mammogram and ultrasound – problem solving.
  • Pre-operative staging
  • Post-operative and/or post-treatment
  • Implant assessment
  • Treatment (neoadjuvant) monitoring
  • Dense tissue

When you arrive

You will change into a hospital gown before going into the scanning area. For safety reasons, you will place your clothing, credit cards, and any objects (such as your phone, jewellery, coins, and glasses) in a locker. This is because objects with even a small amount of metal can fly into the magnet. The magnet can also damage cell phones and credit cards.

Your technologist will bring you to the scanning room and help you onto the MRI table. The MRI machine is a large, donut-shaped magnet. It makes a loud tapping noise during the scan. Your technologist will offer you earplugs. You will lie face-down on your stomach with your hands above your head.

During your procedure

Once you’re comfortable on the MRI table, your technologist will slide it into the magnetic part of the machine and begin the scan. You will be able to speak with your technologist during the entire scan.

It’s important to lie still and breathe normally. You may want to do your relaxation exercises during your scan.

Your breast(s) will be pressed down in order to take pictures. The pictures will help your radiologist find the area they need to biopsy.

The table will be pulled out from the MRI machine. You will be taken in and out of the MRI machine during this procedure. Once they find the area of your breast to be biopsied, you radiologist will give you an injection of a local anesthetic into your breast to make the area numb.

After the area is numb, your radiologist will make a small incision in your breast and insert a thin needle. They will remove samples of tissue or cells. The sample will be sent to the Pathology Department to check it for cancer cells.

Your radiologist will leave a small marker at the area of your incision to help your doctor identify the biopsied area. You won’t be able to feel this marker. Your radiologist will then put Steri-Strips (thin pieces of paper tape) over your incision.

Your procedure will take 30 to 60 minutes.

After Your Procedure

After your procedure, you will need to have a post-biopsy mammogram.

The nurse/technologist will advise you how to care for your biopsy site.

The biopsy results will be sent to your doctor. Please schedule an appointment with your doctor to go through the results.

Contact Information

If you have any questions or concerns, please call Lake, Smit and Partners on 087 310 4984. Alternatively, please get in touch with your doctor.

If you have a medical implant or device, ask the doctor who put it in for the exact name and manufacturer. If you don’t have this information before your MRI, you may not be able to have it that day.

During your MRI you will lie face down on your stomach with your hands above your head for about 1 hour. Your breasts will fit into cushioned holes in the table. If you think you will be uncomfortable lying still or if you’re afraid of being in a narrow or small space, inform the staff ahead of time. They may prescribe medication to help you feel more comfortable.

If you wear a medication patch on your skin, you may need to remove it before your MRI. This is because metal in the patch may heat up during your MRI and cause burns. Make sure you have an extra medication patch with you to apply after your MRI.

The MRI machine makes loud noises during the scan. Practicing relaxation exercises may help you feel more comfortable during your scan.

Injections before your MRI

Contrast is a special dye that makes it easier for the radiologist to see differences in your body. The nurse or radiologist will insert an intravenous (IV) line in your arm to give you your IV contrast.

If you’ve had a reaction to contrast in the past, please inform the staff.

Pregnancy and Breastfeeding

Please inform the staff if you’re pregnant or think you might be pregnant. The contrast injection is not safe in pregnancy and therefore a different test will need to be ordered.

A small amount of contrast is excreted in breast milk following contrast injection. Some people choose not to breastfeed for 24 hours after receiving MRI contrast. If you’re breastfeeding, talk to your doctor about your options.

  • Please remember to bring your medical aid card together with the signed request form from your referring doctor.
  • You must get authorisation from your Medical Aid before your appointment.
  • An appointment time will be given to you.

St Augustine’s Hospital
107 JB Marks Road, Durban
Tel: 087 310 4984