Breast MRI

Advanced breast imaging technology complements mammography

Breast MRI is the most sophisticated imaging available for the breast, and increasingly important in the fight against breast cancer. Promising new evidence shows that for women with increased risk (See ACS Recommendations in sidebar), Breast MRI can potentially decrease mortality by detecting cancers that would otherwise be completely invisible or undetectable by mammograms, ultrasound, or clinical examination.

While mammography is the gold standard to which all breast imaging is compared, and for good reasons, it does not have the power that is available in MRI. While the majority of mammographic abnormalities requiring biopsy are benign, the majority of MRI-detected abnormalities requiring biopsy are malignant. The specificity of MRI is enhanced even further by the ability to use the 3-D MRI information to guide accurate and minimally invasive biopsy of lesions within the breast. Using the spatial information available with MRI guidance, our subspecialists can precisely biopsy abnormalities to confirm if they are cancerous or not.

While Breast MRI is available from many providers, national experts have warned that experience and quality are crucial to success. Our program attributes its success to strict adherence to “the rules” of Breast MRI. The highest quality magnets and equipment are used, and only a few highly-trained subspecialists interpret the cases. Wake Radiology’s Breast MRI subspecialists have performed more than 5,000 Breast MRIs since 2005. One of the most important rules, commonly ignored by others, is the effect of estrogen on the accuracy of the examination. The medical imaging literature has been clear that high estrogen levels negatively affect the accuracy of Breast MRI. Thus, for breast MRIs that are performed to diagnose possible hidden cancer (rather than determine extent of known cancer), we restrict imaging to days 5–14 of the menstrual cycle. This dramatically improves image quality and accuracy.

Our physicians work daily with multidisciplinary teams to further improve diagnosis and treatment optimization. The 3-D images created by this advanced technology provide critical information on the size, extent, and location of the suspected malignancy. If the Breast MRI reveals cancer, the physician has detailed 3-D information to help determine the best course of treatment.

View the video below, Breast MRI: Beyond the Mammogram, a presentation by Dr. Glenn Coates, Co-director of Breast MRI Services for Wake Radiology.

Learn more: All adult imaging procedures