MRI-Guided Breast Biopsy
What Is an MRI-Guided Biopsy of the Breast?
Your physician may order an MRI for a more detailed look at breast tissues for prevention or diagnosis. Sometimes a breast MRI is performed as a preventative imaging scan in high-risk women with a strong family history of breast cancer. These women may undergo regular MRI imaging to look for subtle differences that may represent cancer, as a supplemental imaging scan in addition to mammograms.
A breast MRI can evaluate the extent of disease in patients with a recent breast cancer diagnosis. Contrast MRI imaging looks for additional breast cancers within either breast. It can also provide a detailed map for surgeons before surgery.
Radiologists specializing in women’s imaging look for subtle tissue changes in the breast, including vascular changes found by breast MRI. These changes may be as obvious as a rapidly enhancing mass or as subtle as a non-mass-like enhancement. The radiologist will recommend a biopsy if the test shows a suspicious MRI lesion.
How Do Breast Abnormalities Appear on an MRI?
MRI, magnetic resonance imaging, uses magnets and radio waves to produce detailed 3D imaging of the breast or other organs. A breast MRI helps to distinguish normal tissues from abnormal tissue. Signs that may indicate breast tissue changes can include:
Masses
Lumps
Calcifications
Abnormal tissue
We use contrast to show blood vessels and help identify any potentially cancerous breast tissue, which needs a blood supply to grow. On a breast MRI, the contrast tends to become more concentrated in areas of cancer growth. These areas may show up as white areas on a dark background.
A specialized radiologist with many years of training in women’s imaging and breast imaging interprets the MRI scan images to distinguish the different patterns of vascular uptake in the tissues called enhancement. Some patterns of enhancement in the breast are normal, while others may represent breast cancer. The background parenchymal enhancement (PBE) refers to the qualitative enhancement of fibro glandular tissue. A subtle MRI abnormality will be less evident in a breast with moderate background enhancement. In comparison, an abnormal finding will stand out better in a breast with minimal background enhancement.
The rate of uptake and washout of the contrast is called “kinetics.” Kinetics refers to the rate and pattern of contrast uptake of lesions in the breast. The kinetics do not tell the whole story. We describe the enhancing lesion using the American College of Radiology lexicon called the Breast Imaging Reporting and Data System, or BI-RADS. A rapidly enhancing irregular mass with rapid washout is more suspicious than a progressively enhancing oval mass with plateau kinetics.
Who’s Reading Your MRI?
What to Expect With an MRI-Guided Breast Biopsy
The breast MRI biopsy will be scheduled for a different day than your original MRI because the radiologist needs time to review multiple images and sequences. In addition, your insurance plan may need to authorize the procedure. MRI imaging and biopsy together take about 45 minutes. Please allow an hour if needed.
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