Services
Breast MR
The advanced breast imaging studies performed at First Hill Diagnostic Imaging are designed to provide important information on breast related issues and answers to help improve diagnosis and decision making on treatment options. We are recognized as one of the most experienced, premiere, breast MR facilities in the world.
These exams fall into two basic categories:
- Detection of breast cancer or assessment of the cancer’s extent (contrast-enhanced exams)
- Diagnostic examination of silicone breast implants (non-contrast enhanced exams)
These studies are done on an outpatient basis, using Magnetic Resonance (MR) imaging; high-resolution ultrasound is often used as well. No x-rays are used, and there are only minimal risks associated with these methods, when contrast is used. If you have any further questions or concerns, please contact us.
When is advanced breast imaging used?
Unlike mammography, which is commonly used is for routine breast screening, these specialized exams are only appropriate in specific circumstances to provide additional, complementary, diagnostic information. Please click here for a list of the usual clinical indications for advanced breast imaging.
Cancer Exams
Diagnosis - Magnetic resonance (MR or MRI) and ultrasound imaging are increasingly employed to improve the diagnosis and assessment of the size and extent of known breast cancer. They are also used in high-risk patients or when breast cancer is suspected, but other breast imaging studies have been inconclusive. These exams are for patients whose therapy decisions are likely to be significantly affected by the information provided. Other roles of advanced breast imaging are for biopsy, staging and monitoring.
Staging
When cancer has already been diagnosed, advanced imaging methods are often used for "staging", that is, to determine the extent of the tumor.
Staging defines:
- The size and local extent of the tumor
- The presence of tumor in adjacent lymph nodes
- The presence of distant metastatic tumor in bones, liver, etc.
Monitoring
MR is also used to monitor a tumor’s response to pre-surgical chemotherapy, which is called “neo-adjuvant chemotherapy.”
Implant Exams
MR and ultrasound are also used for breast implants, to determine whether the implants are ruptured and to define the extent of leakage that may have occurred. Please note that MR implant imaging is not designed to, or capable of, diagnosing or ruling out cancer since contrast injections are not used.
MR of the Breast (for cancer)
The MR study of the breasts for cancer uses contrast material that is injected into a vein. The images produced are three-dimensional and have high resolution and clarity.
Breast MR is capable of detecting tumors as small as four or five millimeters (the size of a pea), and the overall accuracy of the test is high. Our physicians are highly experienced in breast MR and pioneered this technique in the Northwest in 1992.
Precautions, Risks and Complications
There are circumstances under which MR imaging should not be done, and others which call for precautions. Before the exam, patients will be asked if they are pregnant or have any metal in their body. They must tell us if they have a cardiac pacemaker, cerebral aneurysm clips, an insulin pump, or other infusion pump, cochlear (inner ear) implant, neurostimulator, Copper-7 IUD or any other metal in the body, especially in eyes. Please click here for MR safety screening.
Preparing for the exam
No advanced preparation is required; you may eat normally and take medication as usual.
For non-urgent exams for possible cancer, we strongly recommend the MR exam be performed 5 to 10 days from the first day of their menstrual period if at all possible.
What to expect
You will be asked to remove any metal objects which could be affected by the magnet: jewelry, watch, dentures, and hearing aids. You will also need to change into comfortable clothing which we provide for your examination. A locker will be available for your use as well. We encourage you to leave any unnecessary valuables at home.
A small intravenous line will be placed in the arm, and you will be positioned on your stomach. Your breasts will rest in a special "breast coil" which receives the MR signal.
During the examination, it is crucial that you remain still and do not move, or the MR image will be blurred. The quality of the MR study depends very much on your ability to hold perfectly still for 15 to 20 minutes.
During the exam, you will be given a small IV injection of an FDA-approved contrast agent. This agent rarely produces reactions Most patients do not feel it at all. If a reaction occurs it is typically mild. It is important to let our staff know if you have any kidney problems.
Throughout the exam, you will hear a loud rhythmic thumping sound and may feel a slight vibration, but there should be no other physical sensations. While the space in the MR machine is adequate, some people feel uncomfortable in it. If you have difficulty being in a confined area or claustrophobia, please let our staff know before your appointment. You may need a moderate oral sedation to be comfortable in the MR scanner. If this is the case, you will need to bring someone to drive you home.