Breast MRI Scan

A breast MRI scan is a highly sensitive imaging examination that uses magnetic fields and radio waves to create detailed images of breast tissue without ionising radiation.

Utilising advanced sequences, such as diffusion-imaging, Breast MRI scans can detect abnormalities that may be difficult to identify on traditional mammography or ultrasound, especially in women with dense breasts.

No. Unlike a mammogram, a breast MRI scan does not require the breasts to be compressed between plates.

During the scan, you lie face down on a specialised MRI table with your breast positioned in a dedicated imaging coils. This face down position, allows for natural spread of the breast tissue without the uncomfortable compression associated with mammography.

Breast MRI also does not use ionising radiation, making it a valuable additional option for patients who wish to avoid compress, have breast implants, dense breasts, or a family history of breast cancer.

MRI is more sensitive to breast cancer than other types of breast scans. Because of this, a Breast MRI may be recommended in the following circumstances:

• Known dense breast tissue
• Further investigation of abnormality on mammography
• Pre-surgical planning after positive breast cancer biopsy
• Monitoring treatment response for women opting for breast tissue conserving therapies
• Surveillance after breast cancer
• Assessing breast implants for rupture

Patient preferences are also important aspects of healthcare. We encourage patients to discuss with their doctor whether Breast MRI is right for them in the following circumstances.

• Wish to avoid painful compression associated with mammography
• Concerns about the theoretical risks associated with breast implant silicone “bleeding” with mammography
• Concerns about ionising radiation associated with mammography
• Desire to minimise number of investigations as a result of common inconclusive findings
• Desire to minimise risk of false negatives

Dense breasts refer to the proportion of fibrous and glandular tissue in the breast compared with fatty tissue. The more fibrous and glandular tissue, the denser the breast tissue.

Understanding whether a women has dense breasts is important when considering the most appropriate, personalised approach to breast cancer screening. This is because dense breast tissue is a risk factor for developing breast cancer, as well as, it makes cancerous lesions difficult to detect early.

However, there is no way to tell whether a women has dense breasts based on how they look or feel. A screening mammography is the traditional approach to learning about breast density. On mammography, breast density is categorised using the BI-RADS Breast Density Classification. There are four categories:

• A = breast tissue is almost entirely fatty
• B = scattered areas of fibroglandular tissue
• C = dense
• D = extremely dense

Both categories C and D are considered dense breast tissue.

These categories are intended for mammography use; however, other cross-sectional imaging can score breast density in a similar manner.

Breast MRI is one of the most sensitive imaging techniques available for breast cancer, particularly in women with dense breasts or at an increase risk of developing breast cancer (e.g. known BRCA mutation). Current published research suggests breast MRI has a sensitivity of 95% or more. In other words, MRI correctly identifies cancer 95% of the time.

A recent 2020 study of over one-thousand women with dense breasts undergoing breast cancer screening compared the sensitivity of abbreviated MRI breast (no DWI or ADC) with 3D mammography (digital breast tomosynthesis, DBT). The abbreviated protocol was reported to detect approximately 2.4-times more cancers compared to 3D mammography in this group of women with dense breasts. In this study MRI correctly identified cancer 96% of the time, where as 3D mammography sensitivity was only 39.1% in women dense breasts.

Note: the authors compared an abbreviated protocol without diffusion imaging. Diffusion weighted imaging (DWI) is an immensely valuable addition for detecting cancer. However, the clinical utility of DWI, particularly in areas prone to distortion (e.g. breasts, lungs, chest wall) is highly-dependent on scanner capabilities and optimisation.

Breast MRI is more sensitive than mammography for detecting breast cancer, particularly in women with dense breasts. However, whether breast MRI is the better examination depends on what is being investigated and the patient’s individual circumstances.

Mammography does have one advantages over breast MRI. For example, mammography can directly identify microcalcifications, tiny calcium deposits that may be associated with very early breast cancer, particularly ductal carcinoma in situ (DCIS). A breast MRI does not directly visualise these tiny calcifications; however, has its own advantages. With diffusion-imaging, MRI can visualise small changes in cellular-density, known as “restriction”. Additionally, MRI has a greater ability to characterise breast tissue or abnormalities, reducing the risk of inconclusive findings.

Ultimately there is no best test for breast cancer screening for all women. Everyone woman should discuss with their doctor about breast density, genetic risk factors and personal preferences in the context of the benefits and risks of mammography and breast MRI.

Individuals often ask, “if breast MRI is the most sensitive ways to detect breast cancer, why isn’t it used for all women with dense breasts?”

Interestingly, and ironically, the answer isn’t simply about diagnostic sensitivity or accuracy.

Despite existing randomised control trial evidence of benefit in women with dense breast over traditional screening, the uptake of breast MRI in this group is slow due to factors such as cost, limited MRI availability, and healthcare resources.

While MRI isn’t appropriate for everyone, its limited use in routine screening does not reflect a lack of evidence supporting its benefit in select women.

A breast MRI scan at MBR Health is approximately 60 minutes of scan time. Our breast MRI scan protocol is a comprehensive multi-parametric study including high-resolution anatomical and advanced diffusion-imaging sequences.

Following a biopsy-confirmed breast cancer diagnosis, breast MRI may be recommended before surgery to provide a more detailed assessment of the extent of disease.

High-quality breast MRI can help surgeons understand the size and location of a tumour, identify additional areas of concern and plan the most appropriate surgical approach. This may be particularly valuable when the extent of cancer is difficult to determine using mammography or ultrasound.

Breast MRI can also play an important role in monitoring response to treatments such as chemotherapy, helping clinicians assess changes in tumour size and extent over time.

Following treatment, MRI may be useful in selected cases to help distinguish recurrent cancer from post-surgical scar tissue.

Yes. Breast MRI typically uses IV contrast when screening for or investigating breast cancer. Contrast helps radiologist identify abnormal tissue enhancement, which can reveal cancers that may be difficult to detect on mammography or ultrasound.

Though the MRI itself is not painful, you will be asked to stay still and regulate your breathing to get the best possible images.

Some people can find lying still in an enclosed space difficult. If you struggle with confined spaces, you may require a light sedative, so it is a good idea to discuss this with your referring doctor prior to having your MRI.

No. Unlike mammography and cone-beam CT breast scan, Breast MRI does not use ionising radiation.

At MBR Health our reception team will provide you with preparation instructions.

For pre-menopausal women, we aim to book your Breast scan between days 1 and 6 of your menstrual cycle. This is because breast tissue changes throughout a women’s menstrual cycle, and scheduling between these days helps to minimise background breast tissue enhancement and improve interpretation.

We also ask individuals to fast for two hours before the scan and to arrive to the clinic 30 minutes early.

Please let our team know if you are pregnant or have any implants, or foreign objects in or on your body prior to arriving for your scan.

Prior to your scan you will be asked to complete a breast health and MRI safety questionnaire. Our MRI team will answer any of your questions before confirming your MRI safety and show you to the scan room.

At MBR Health, all of our Breast MRI scans are reported by breast subspecialist radiologist.

At MBR Health, due the the specialist nature of these scans and reports, your Breast MRI report is expected to be reported and sent to your referring doctor in approximately one-week.

Unique to MBR Health, there are no holds on patient report access via our MBR Health patient app. This means you get your results as soon as it is authorised by the radiologist, at the same time as your referring doctor.

Yes. Breast MRI is a highly effective way to assess silicone breast implants, particularly when an implant rupture or silicone leakage is suspected.

MRI can help detect ruptures that may not be obvious from physical examination, including cases where the implant has ruptured but the silicone remains contained within the surrounding scar capsule.

In some cases where breast MRI may not be suitable (e.g. financial considerations or contraindicated implants such as pacemaker or neurostimulators), MBR Health’s Spectral Breast CT scan, including our Australian-first non-compression 3D Spectral CT breast protocol may be a alternative. For more information, speak to MBR Health’s friendly reception team.

In Australia, Medicare rebates are available for breast MRI scans under certain clinical circumstances. However, Medicare eligibility depends on the reason for the scan, referral requirements and the imaging provider’s Medicare licensing status.

At MBR Health, breast MRI scans are privately billed and do not currently attract a Medicare rebate.

Read our Insights article for more information on Medicare Eligibility and MRI scans

Contact Us to speak to our friendly reception team for more information on costs and appointment availability.