Oklahoma
Breast Care Center
Offers Dedicated Breast MRI
The
technology for detecting breast cancer is reaching new dimensions.
In December 2003, the Oklahoma Breast Care Center became the ninth
facility in the country to offer MRI Breast Imaging. The breakthrough
technology, known as Aurora, is the world’s first FDA-cleared
dedicated breast Magnetic Resonance Imaging (MRI) system.
Since
opening their doors in 1986, the Oklahoma Breast Care Center has had
many firsts;
the first
freestanding
breast imaging facility in the state, the
first to bring stereotactic breast biopsy to Oklahoma, and the first to bring
en-bloc breast biopsy to the Southern United States just to name a few. Dr.
Larry Killebrew, founder and Medical Director, is a world-renowned authority
in breast disease and recently was a presenter at the Radiological Society
of North America.
MRI
is a sophisticated technology that uses a computer, magnetic field and radio
waves – instead
of x-rays – to
produce images of the soft tissues in the body. MRI has been safely used for
decades to provide information
to help in the early diagnosis and treatment of breast disease.
“It
is becoming standard practice to perform MRI on both breasts in women who are
recently
diagnosed
with breast cancer,” said Dr. Killebrew. “The
reason for this is because of the known incidence of multi-focal and bilateral
breast cancer. We also know that MRI has the ability to find subtle, small cancers
in dense breast and high-risk patients.”
MRI
of the
breasts
has
emerged
as
a new technique in the evaluation of breast disease. When used in conjunction
with mammography and ultrasound, breast MRI
can provide valuable information for the detection and characterization of
breast disease. MRI doesn’t replace mammography – it’s a
different imaging technique that provides additional information.
The
Aurora is designed to scan both breasts simultaneously without the discomfort
of breast compression or radiation. An injection of a contrast enhancement
agent is administered through an IV which helps to highlight various structures
in the breast tissue. Through the MRIs high-resolution, high-contrast
capabilities, hundreds of thin-slice computer-generated images from multiple
directions are provided. MRI has the capability to depict very small anatomical
structures of the breast which are evaluated for abnormalities and disease.
MRI-guided breast biopsies can also be easily performed utilizing core
needle and vacuum assisted methods.
Taking 45
minutes from start to finish, it is ideal for a wide range of indications in
breast
disease
management,
including:
Exclude the existence
of cancer in high-risk women based upon family history, genetic markers
or high-risk histology.
Identify
and characterize malignant vs. benign lesions in women with uncertain
mammography and/or ultrasound findings and thereby reduce the number
of biopsies
resulting from false positive mammograms and/or ultrasound examinations. These
attributes are especially important in women with impaired mammography due
to
dense breast tissue.
Breast MRI performed soon after surgery may be indicated to determine the presence
of significant residual disease in patients with positive surgical margins and
thus aid in the determination of further surgery, either re-excision of margins
or mastectomy.
Breast MRI
may be indicated to distinguish postoperative and/or post-radiation therapy
scarring from recurrent cancer. MRI may also be useful in evaluating chemotherapeutic
effectiveness. And to monitor the effectiveness of chemo-preventive therapy
such as Tamoxifen.
Breast MRI may be
indicated to detect obscured primary breast cancer in women presenting with
metastatic disease and no known primary tumor. MRI may also be
indicated to detect subtle disease in the opposite breast or multifocal/multicentric
disease in the same breast.
Determine the extent of breast cancer prior to treatment; determine the feasibility
of breast conservation vs. mastectomy and the potential need for radiation, chemotherapy
or chest wall resection. MRI may be particularly useful to determine the extent
of disease in women with lobular carcinoma histology.
Evaluate implant integrity and detect cancer in women with breast augmentation.
MRI is the most reliable method for imaging breasts to determine implant rupture
or leakage. As opposed to mammography and ultrasound, breast MRI is not impaired
by the presence of silicone injections or implant augmentation in the detection
of cancer.
FREQUENTLY ASKED QUESTIONS ABOUT MRI
WHAT SHOULD I EXPECT TO HAPPEN DURING MY EXAM?
The Aurora is designed specifically for your comfort. During the exam, you will lie on your stomach with your breasts placed in openings in the Aurora examination table so that they’re suspended away from your chest. Unlike mammography, breast MRI doesn’t require your breasts to be compressed, so you shouldn’t experience any discomfort. Plus, you’ll enter the machine feet-first, which reduces feelings of claustrophobia sometimes associated with full-body MRI scanners.
You’ll receive an injection (usually in the arm) of a contrast enhancement agent called gadolinium that helps to highlight various structures in breast tissue. The gadolinium is administered through a small intravenous catheter which is placed by a certified technologist.
An initial scan will be taken and then repeated after the gadolinium is administered. For best results, you should lie very still, relax and breathe normally. You can communicate with the technologist at all times. The entire exam takes about 45 minutes.
HOW DO I PREPARE FOR THE TEST?
No special preparation is required. You can eat and drink as you normally would, engage in regular activities and take any prescription medication.
You’ll be asked to change into a gown since belts, zippers, snaps and thread in clothing may contain metal that disturbs MRI signals. We’ll ask you questions before you enter the MRI exam room to confirm that you don’t have any metal in or on your body. You’ll have to remove all metallic objects such as jewelry, glasses, hairpins and dentures (personal belongings can be locked in a locker). Please be sure to tell the technologist if you have metal implants, a cardiac pacemaker, permanent dental bridges, braces or other metal objects.
Many cosmetics contain lead, especially mascara. We may ask you to remove your makeup prior to the exam. Avoid heavy use of antiperspirant and no body powder.
WHAT ABOUT AFTER THE TEST?
There are no side- or after-effects with MRI, so you can resume your normal activities as soon as your exam is over. The radiologist will interpret your MRI scan and report the findings to your physician.
DOES INSURANCE COVER BREAST MRI?
Your insurance carrier determines if breast MRI is a medical necessity. Precertification may be necessary. Your insurance company will need to be notified 24 hours prior to your exam. Contact our office to be sure we have obtained the necessary paperwork prior to your appointment.
For more information on dedicated breast MRI or to schedule an appointment call the Oklahoma Breast Care Center at (405) 755-CARE (2273) ext. 130.
BREAST MRI FACTS:
• It uses no X-ray radiation
• It does not require uncomfortable breast compression.
• It does require the injection (usually in the arm) of a contrast enhancement agent
called gadolinium that helps to hightlight various structures in breast tissue. The
gadolinium is administered through a small intravenous catheter which is placed by a certified technologist.
