Breast MRI uses a powerful magnetic field and radiofrequency waves instead of x-rays to produce high resolution detailed images of the breast. This non-invasive procedure helps our board-certified mammography trained radiologists to detect any additional cancers not visible with both mammography and ultrasound. When used in conjunction with mammography, it provides value added information for both your surgeon or referring clinicians.

Please note possible limited sensitivity for detecting low-grade or early DCIS with MRI. MRI should not be used to replace screening mammography. In addition, suspicious findings on the mammogram or presence of a palpable abnormality despite a negative MR may still prompt a biopsy.

MRI also has a higher false positive rate (where the test finds things that turn out to benign or normal), which could result in biopsies and other tests.

In March 2007, the American Cancer Society (ACS) revised the breast cancer early detection guidelines, recommending annual breast MRI screening for women in the following groups:

• known BRCA1 or BRCA2 gene mutation

• first-degree relative (mother, father, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves

• have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on a family history (for example, Gail Model).

• had radiation therapy to the chest when they were between the ages of 10 and 30 years

• have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives

• have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)

• have extremely dense breasts or unevenly dense breasts when viewed by mammograms

Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Breast MRI detects otherwise occult cancer with an overall added cancer yield of 12% and a high positive predictive value of 44% when applied to a diverse population of patients with newly diagnosed breast cancer according to a recent study. (Robert L. Gutierrez, Constance Lehman MD AJR. 2011 ).

You will be asked to arrive 30 minutes before your appointment time. The entire study will take 45 minutes to an hour. Unless you were recently diagnosed with breast cancer, this exam should be scheduled 14 days after the start of your menstrual cycle. This timing is important to minimize false positive findings that can occur due to hormonal influence on the breast tissue.

During the exam, you will lie on your stomach with your arms over your head. The MR table will move in with your head first. Please avoid eating a large meal prior to the exam. You will receive an injection of contrast material called gadolinium during the exam. A small intravenous catheter will be placed in your hand or arm before the actual study. This injection of contrast material is necessary for detecting breast cancer. The contrast we use is extremely safe and adverse reactions are rare.

You will be asked to lie very still and breathe normally. The MRI scan will only take 25-30 minutes.

It is important to bring any breast imaging tests (mammography, ultrasound or MRI) with you to your appointment. Our radiologists will use these tests for comparison with your MRI.

Ultrasound imaging of the musculoskeletal system provides images of muscles, tendons, ligaments, joints and soft tissues throughout the body.

• Used to complement MRI

• Non-invasive and is usually painless

• No radiation

• Excellent alternative to MRI for severely claustrophobic patients

• Effectively images tendons and ligaments in patients who can not have an MRI for a variety of reasons.

• Image-guided therapeutic injections to treat tendinosis, arthritis, neuromas and other conditions, such as tennis elbow;

• Image-guided aspirations of bursa, ganglions and cysts;

• Detection of tiny foreign bodies in soft tissues;

• Ultrasound-guided needle aspiration of shoulder calcific tendonitis;

• Real time dynamic evaluation of tendons.

• Fenestrations of tendon for treatment of tennis elbow or plantar fasciitis.

Yes. We strongly urge you to discuss this study or procedure with your primary care physician.