MRI of the female breast

introduction

Diseases of the female breast are not uncommon; they range from inflammation and benign lumps to cancer (e.g. breast cancer) and can affect all age groups. However, breast cancer can also occur in men.
In order to be able to recognize dangerous clinical pictures quickly and to classify them correctly, a comprehensive diagnosis with imaging of the tissue concerned is important.
One of the most modern and gentle procedures is the MRI examination of the breast.

definition

MRI -abbreviated for magnetic resonance tomography- or nuclear spin is an imaging process that, as the name suggests, works with magnetic fields.
Exposure to radiation, like the roentgen, of the Mammography or the Computed Tomography (CT) is not given here.

In MRI, the physical properties of water molecules are used in such a way that different tissues appear differently according to their water content. It means that Soft tissue, which contains more water than bone, can be examined particularly well with this method.
These include e.g. Cartilage or ligaments, and that too female breast.

Cause / application

1. Use of MRI in early detection

The standard procedure for detecting changes in the breast is usually the Mammography . Usually there is also a Ultrasonic drawn into the chest.

In some cases, however, these methods are not sufficient to make a clear statement about the condition of the tissue. If one compares the procedure, then with the mammography the entire breast is x-rayed at once, in a sense you only get a shadow.
With MRI, on the other hand, individual layers are produced in cross-section, which allows a much better view of the tissue of the breast and also allows statements to be made about the exact location of changes.

In the case of a young woman, whose breast is often still made up of very dense glandular tissue, it can sometimes be difficult to obtain a meaningful picture with the mammography. In such a case, a chest MRI is indicated (Technical term: breast MRI).

Women, the one familial incidence of breast cancer show or who even have a hereditary predisposition (the so-called breast cancer gene BRCA-1 or -2) are predestined for examination and diagnosis using MRI.
At this risk group be regular Screening exams already performed by means of imaging from the age of 25 or 30 (and not from the age of 50, as usual).
If one were to use a method that uses radiation so early and regularly, this would also increase the risk of developing breast cancer.

Even benign changes can sometimes go to the bottom for one Cancer become. They must also be observed regularly.
An MRI examination of the breast thus reduces additional radiation exposure and lowers the risk of degeneration.

Another reason for the MRI may be the presence of Breast implants be. Due to the silicone pads, changes in the image may not be visible during a mammography.

2. Use in monitoring the progress of breast cancer

If breast cancer has already been diagnosed, an MRI of the breast can be performed process control can be used.
Very small foci from 4-5mm, which cannot be seen in the mammography, can be detected and clarified in the MRI. The exact extent of the tumor is often difficult to assess in mammography and ultrasound, since only calcifying tumor parts are visible there and growth within the gland ducts cannot be assessed.
The MRI provides much more precise images for this and should be pioneering before an operation in order to really be able to completely remove the cancer.

During one chemotherapy The regression of the tumor can be assessed with the MRI and after completion of the treatment it is possible to distinguish between remaining scar tissue and a possibly newly developing tumor.

Procedure for an MRI scan of the breast

Of the procedure an MRI scan is mostly similar. The device corresponds to a 1 meter long tube with an inside diameter of approx. 60 cm - 1 meter. This somewhat cramped space assumes that the patient is not under Claustrophobia (claustrophobia) suffers.

You can find further information under our topic: MRI for claustrophobia

The examination is carried out in the prone position on a movable table. The chest rests in a special shell that gives the chest space and cushions it. Depending on the device, the arms can be put on or stretched out.
When the patient is well positioned, the table is moved into the tube and imaging can begin. This takes about 20 minutes and is typically done with a strong noise connected. Against the loud and sometimes high-frequency knocking noises, the patient receives protective headphones. There is always one for emergencies Stop button and the patient survives microphone in constant contact with the staff.

An MRI scan is always with the emergence of strong magnetic fields connected, should accordingly metallic objects are always removed from the treatment room become. This includes everyday objects such as cell phones, keys, coins and belts, but also credit cards (they can be deleted). Body jewelry (Earrings, piercings of all kinds, chains, rings) must be removed, especially the underwires of a bra can affect the quality of the image.

Metallic objects in the body should definitely be mentioned before an examination!
If Pacemakers, cochlear implants, fixed braces, Joint prostheses or foreign objects such as shrapnel may not be possible.
On too bigger tattoos Attention should be drawn to the fact that metal dust in the ink can heat up in the magnetic field and burn the skin.

Female cycle and breast MRI

The time of the examination must be after female cycle be judged if there is regularity. Days 8-16 represent the optimal period for this, because before and after the breast tissue is exposed to hormonal changes and is less suitable for an assessment.

Contrast media for an MRI of the breast

If necessary, the MRI of the chest with a Contrast media prepared. This means that a liquid that is particularly well visible in the image, e.g. Gadolinium, is given into the patient's bloodstream through a venous line. Regions with good blood supply to which a tumor, e.g. Breast cancer can be represented particularly well.

Further information is also available at: Contrast media and MRI with contrast agent

The administration of contrast media rarely has side effects, but should be in patients with a impaired kidney function may be dispensed with.

Results

If a tumor, i.e. a mass per se, is actually discovered in the image, this does not necessarily indicate a malignant finding (e.g. breast cancer).
Only tissue removal (biopsy) and a subsequent histological examination (histology) decide whose findings are decisive for the further procedure.

Read more on the subject at: Breast biopsy

Cost of an MRI scan of the breast

The costs for a MRI of the chest are unfortunately rarely covered by the statutory health insurance. Patients with a hereditary problem, i.e. a mutation in the BRCA-1 gene (breast cancer gene), are only covered by a study by the German Cancer Aid.

For self-payers, a breast MRI costs around 300 - 400 euros. Considering the advantages for diagnostics (especially before surgery) However, this investment could be worthwhile.

The costs for those with private insurance are higher. The costs vary depending on the complexity of the examination, three-dimensional reconstruction of the images or the contrast agent. Costs between € 400 and € 700 must be expected.

You can find more detailed information at Cost of an MRI examination