Breast MRIs : What are they like?

After my initial Breast Cancer diagnosis, my surgeon ordered a breast MRI for me. It was quite an involved imaging test, and there were a few things about the process that surprised me. If you are facing a breast MRI, I hope that this post can help you prepare better for this procedure.

Important Note: I am not a doctor. I am sharing my personal patient experience. Please follow your doctor’s advice.

Breast MRIs are not a part of the standard screening procedure for most women.  This is because the technology has benefits and drawbacks. While a breast MRI can pick up a lot of things that aren’t visible under a mammogram or ultrasound, it is also very common to have false positives as a result of the screening. Additionally, an MRI is a very expensive scan, so insurance companies typically don’t approve this scan unless there is a clear medical reason for it.

I had my first Breast MRI after my DCIS diagnosis. My surgeon was clear that he wanted to make sure that the imaging workup on me was complete so that he could feel confident with the surgical plan. His initial recommendation for me, based on my biopsy, was to remove the DCIS with a lumpectomy because it was so small. However, he didn’t want to recommend a surgical plan without genetic testing and MRI screening.

If you have had a biopsy that indicates breast cancer, I would highly recommend you talk to your surgeon about an MRI. Certain types of cancer are harder to detect with mammography or ultrasound, and the MRI may be able to give your medical team more information. Not every screening facility has the ability to do a breast MRI, so you may need to go to a different location to get that test done.

Timing is Important:

If you are still having periods, it is really important that your breast MRI is scheduled at the beginning of your cycle.  This will reduce the number of false positives that occur.  

When you call to get your Breast MRI, be prepared with an idea of when your cycle starts so that the MRI can be scheduled at the right time of the month for you.

What to Expect:

When you arrive for your MRI, be prepared to change into MRI safe clothing that the office will provide you. It’s also important to remove any metal that you might have on. There are a variety of screening questions that the technologists will ask you as you prepare. One of the more interesting ones was, “Do you have any metal fragments inside of you?”  These are all important questions to ask because the MRI is a giant magnet. You do not want to be wearing anything metal during the screening.

I chose to wear contacts instead of glasses on my breast MRI days. I wanted to be able to see during the setup and be comfortable during the test. I am very nearsighted, and I felt like I would be more anxious throughout the test if I wasn’t able to see.  

Make sure that you use the restroom before you go into the screening room. This test takes between thirty minutes and an hour, and you don’t want to need to get up in the middle of it!

Preparation for the Scan

Once you are dressed in MRI safe clothing, it will be time to go into the testing room. The device should already be set up for your scan. In a breast MRI you will be lying down on your stomach, and your breast will be hanging through the table through special holes.  

Breast MRIs are usually performed in traditional MRI tubes, so you will be going into an enclosed tube for an extended period of time. If you are claustrophobic or feel anxious during these types of tests, make sure that you talk with your doctor about anti-anxiety medicine for the procedure. For this to be a successful scan, you will need to be in the MRI tube for at least 30 minutes. If you feel like you might need medicine to help you be calm during the scan, then please ask for it!  

IV Time

Before the scan begins, the tech will be placing an IV.

For my first MRI, I was not prepared at all for this testing twist. I’d had an MRI before, but it was done without contrast.  

Breast MRIs are done with contrast. The way this works is that you will have an IV placed before the scans begin. Then once the first scans are complete, the technician will inject the contrast into your IV, and then the scans will be done again.

The contrast will light up any areas of concern in the breast. It also has the potential to light up benign areas of the breast as well.

So, you are in the room, and the IV has been placed. Then, you will be given some earplugs. Take some time to make sure that those are inserted well into your ears. If you have small ear canals and feel like the generic-sized earplugs aren’t working well for you, please ask for help. You want to protect your hearing during the scan.

Positioning- Make Sure You’re Comfortable!

Then it’s time to get positioned for the MRI.

You will be lying down on your stomach on the scanning table. This table is remote-controlled so that the technologists can move you in and out of the tube from the scanning room.

As you are getting positioned, pay special attention to the padding on your chest bone between the breasts. Make sure you are comfortable with the amount of padding they place there. During my first MRI, I was so uncomfortable because there wasn’t enough padding there for me. 

If you are feeling cold, ask for a blanket. Also, some locations will offer some supplementary things to help you feel more relaxed during the scan. I was offered aromatherapy during my MRI-guided biopsy, and I was able to pick the music that was piped into the room. I chose to have classical music and lavender aromatherapy during my MRI.  It really helped make the situation a lot more pleasant.

As you are getting prepared for this test, please ask your questions and if you are feeling scared or you’re in pain, please say something. As they are moving you into scanning position, you’ll likely need to have your arms in a specific position. If you’re not comfortable, please let the techs know. Let’s get the positioning right before the test is done!

MRI Time

So, now you’re positioned, face down on the table, in massage position, with no masseuse! Now it’s time for the scan to begin. You will be given a button that you can push to talk to the technoligists during the exam.  

The tech will exit the room and then they will talk to you through the intercom once they are ready. Make sure you can hear them when they are talking to you.

You will then be moved into the tube. You’ll likely be hearing the whooshing of the MRI magnet a bit louder once you’re inside the tube.  

Once the tech is happy with the positioning, they will start talking to you through the scans. There will be several done and they will last anywhere from between 30 seconds to several minutes. Expect the tech to tell you how long each scan will take before it starts. Once the scan starts, the machine will start a clicking noise, and it will get loud.

Your job is to be calm and to stay still. If you move, the quality of the scans will be disrupted.

One set of scans will be done without contrast, and then the technologist will usually tell you that it’s time to insert the contrast. You might feel a cold sensation coming from the IV. That is normal.

Then the scans will be repeated, this time with contrast. It’s really important to stay still because they only get one shot at getting the pictures with the contrast.

After the Scan

Once you’re done, the table will be moved out, and the tech will reenter the room. You’ll be able to sit up, and the IV will be removed.

I would discuss with the tech, and also your ordering surgeon, how the results will be communicated to you. My surgeon likes to discuss things in person, so I always make sure to have an appointment on the books after my scans.

As long as you are feeling well, you will be able to get up and go back to find your regular clothing.  

I was able to drive home myself after my latest breast MRI. But, if you have never had a Breast MRI, or you needed to take an anti-anxiety medicine, you should plan to have a driver take you home. I always think that it is wise to have help available, especially as we are facing new tests.

Breast MRIs are excellent planning tools when used in conjunction with Mammograms and Ultrasounds. However, false positives are possible. This doesn’t necessarily mean that the breast cancer is worse. But, it does mean that further scans or biopsies might be needed after your MRI results are read. In my case, I needed to have three additional biopsies after my Breast MRI. It did delay my surgery, but I was grateful that my team was being as thorough as possible.

Here are some resources that I found that are helpful to learn more about Breast MRIs and why they might be ordered for you.

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/breast-mri

https://www.breastcancer.org/symptoms/testing/types/mri/how_performed

Do I Need a Breast MRI?