Abnormalities in the breast may mean something serious, like breast cancer. These abnormalities have to be detected and addressed as soon as possible before they are no longer manageable. One of the ways to detect them is through MRI-guided breast biopsy. An expert performs an MRI-guided breast biopsy, revealing breast abnormalities that other tests cannot disclose. At Los Angeles Diagnostics, we use state-of-the-art equipment to perform biopsies. Our services are comfortable and professional, thanks to our experienced radiologists. If you wish to undergo a biopsy, please do not hesitate to call us for consultation.
Breast Biopsy Overview
A breast biopsy is a procedure to extract breast tissue samples for testing. The sample is taken to a laboratory, where pathologists (doctors specializing in analyzing body tissue and blood) examine them and diagnose.
Your doctor may recommend that you undergo a breast biopsy procedure if there is a suspicious spot in your breast, for instance, a lump or any other breast cancer symptoms and signs. Doctors also use this procedure to investigate unusual results on an ultrasound, mammogram, or any other breast examination.
Breast biopsy findings can reveal whether the spot on your breast is cancer of the breast or if it is noncancerous. The pathologist’s report after the biopsy can assist your physician in determining whether you have to undergo further surgery or need other treatment. There are several kinds of breast biopsy procedures, including fine-needle aspiration biopsy, core needle biopsy, stereotactic biopsy, ultrasound-guided core needle biopsy, and MRI-guided breast biopsy. This article talks about MRI-guided breast biopsy.
MRI-Guided Breast Biopsy
An MRI-guided breast biopsy is a type of core needle biopsy performed under the guidance of an MRI. An MRI is an imaging method that captures and combines several cross-sectional images of body tissues and organs, using radio waves, a computer, and a powerful magnetic field. In this case, an MRI helps locate the abnormality in the breast, such as a lump.
Once the radiologist finds the abnormality, they will guide a core needle into the breast to extract a sample of the breast tissue or cells for examination by a microscope. At times breast abnormalities become a problem in the long run. If there is any problem with your breast, early detection is essential and increases treatment options and the chance of successful recovery. MRI-guided biopsy uses no ionizing radiation. It also leaves little or no radiation.
Why Breast Biopsy is Done
Mammography, physical, and other examinations often detect abnormalities or lumps in a breast. But these exams cannot always disclose whether the abnormality or lump is cancerous or benign. Physicians conduct breast biopsy procedures to extract a small portion of tissue or cells from an unusual spot in the breast for laboratory analysis. The physician may conduct a breast biopsy surgically. But more commonly, radiologists use a minimally-invasive procedure involving image guidance and a hollow needle. An image-guided needle biopsy usually does not extract the whole lesion. Rather, it acquires a sample of the affected breast tissue for more analysis in a lab.
Image-guided breast biopsy uses mammography, MRI, or ultrasound image guidance to obtain a sample of a given abnormality. In this biopsy, MRI guides the technologist's tools to the area where the lesion is.
MRI-guided breast biopsy comes in handy when an MRI reveals an abnormality in the breast, for example:
- An area of distortion
- An area experiencing an abnormal change of tissue
- A suspicious clump that other imaging methods failed to identify
Preparing for MRI-Guided Breast Biopsy
When you set up an appointment for your exam, your doctor will assess your medical history and the medication you are presently on, if any. Inform them of all the medications you take, including herbal supplements. If you are using aspirin, certain herbal supplements, or blood thinners, your physician may ask you to cease taking them five to seven days before the procedure to help lower the risk of bleeding.
The MRI magnetic field is safe, but it might cause the malfunctioning of some medical appliances and devices. Most orthopedic implanted devices do not pose any risk. However, you must always inform your radiologist if there is any metal or device in your body. Tell them if you are implanted with a breast tissue expander, AICD (Automatic Implantable Cardioverter-Defibrillator), aneurysm clip, pacemaker, or any other device implanted in your body.
If you usually wear an insulin pump, CGM (continuous glucose monitor), or medication patch on your skin, your radiologist may ask you to take them off before the biopsy. If you usually change your device, speak with your doctor about setting your biopsy appointment close to the day you will be changing it. Also, ensure you have another medication patch or device with you for wearing after the biopsy.
Some MRI tests use contrast dye injection. Your physician may ask whether you are asthmatic or allergic to contrast dye, the environment, food, drugs, or anesthesia. MRI exams usually use gadolinium contrast. Physicians can use this contrast in patients with an allergic reaction to iodine contrast. Patients have a lower chance of developing an allergic reaction to gadolinium contrast than iodine contrast. But even if you are allergic to gadolinium, you may use it once the doctor administers proper pre-medication.
Inform your radiologist or technologist if you suffer from any medical condition or have had recent surgical procedures. If you have a medical condition like chronic kidney disease, it may not be safe for you to receive gadolinium. Your radiologist may need you to undergo blood testing to establish whether or not you have healthy kidneys.
Tell your radiologist or doctor if you are pregnant or believe you may be pregnant. No study has shown the ill impact of MRI on pregnant patients or unborn infants. However, the infant will be exposed to a powerful magnetic field. Thus, if you are pregnant, you should not undergo an MRI exam in your first trimester, except if the advantages of the test surpass any possible risks. You should not be injected with gadolinium contrast if you are pregnant unless necessary.
Guidelines about drinking and eating before an MRI-guided biopsy vary between health facilities. If sedation is necessary, arrange for someone to take you home after the procedure.
If an MRI-guided breast biopsy is unsafe for you, your physician will recommend a different exam. If you have questions about the biopsy, call your physician's office.
Preparing for the Procedure
On the due day, drink and eat normally unless your radiologist or doctor tells you otherwise. Put on loose, comfortable clothes and do not wear jewelry. Your radiologist may ask you to put on a hospital gown to prevent artifacts from appearing on the final images and for compliance with safety regulations related to the powerful magnetic field.
Do not wear any lotions, deodorant, perfumes, or powder on your breasts and underarms. The hospital staff will provide you with a moist towelette if you need one, and you will be given deodorant after the exam. Since the MRI machine can be loud, you can request the staff to play your favorite music during the procedure.
What Happens During the Procedure
You will be required to wear a gown before entering the scanning room. You will place your belongings (clothes, credit cards, coins, jewelry, phone, glasses, purse, and other objects) away in a provided locker for safety purposes. This is necessary because items with even the smallest amount of metal can fly into the MRI's magnetic field. The magnet may also damage credit cards and cell phones.
What to Expect During the Procedure
Your doctor will put an IV (intravenous) line in your vein, often in your hand or arm, and administer gadolinium contrast intravenously. Your technologist will describe the process and address all of your concerns. Additionally, they will need you to sign a consent form, which states you consent to the MRI. The radiologist will then take you to the scanning area and help you on the MRI table.
You will lie on the MRI table on your stomach, face down with your hands above your head for thirty minutes to one hour. Your breasts will fit into padded openings in the MRI table. As we mentioned, the machine produces loud tapping noises while scanning. Talk to your doctor beforehand if you are scared of small or narrow spaces or believe you will not be comfortable lying still. The doctor may prescribe drugs to help you be more relaxed and comfortable.
Once you are lying comfortably, your radiologist will slide the MRI table into the magnet and start the scanning. You will slide in the scanner several times. You will be capable of communicating with your radiologist during the whole scan. You have to breathe normally and stay still. You may have to do relaxation exercises while being scanned.
Your breasts are gently compressed to capture pictures. These pictures will assist your radiologist in finding the place in your breast they have to biopsy. After locating the area, they will inject the breast with an anesthetic. Once the site is numb, they will make an incision in the breast and place a thin needle. The technologist will use computer software to measure the position of the lesion and determine the depth and position of needle placement. They will then remove cells or tissue samples, which they will send to a lab for a pathologist to examine for breast cancer cells.
After extracting the sample, the radiologist removes the needle. The technologist may leave some metallic marker at the place where the made the incision to assist your doctor in identifying the biopsied site. They may use mammography to affirm that the marker is appropriately positioned. You will not feel the marker. After that, the radiologist will exert pressure on the incised place to stop the bleeding, if any. They will then dress the incision using Steri-StripsTM. Sutures are not needed. The procedure will last thirty minutes to one hour.
After your biopsy, you will have a mammogram. After the mammogram, your radiologist will put a bandage on the Steri-StripsTM.
You will remain awake throughout the biopsy procedure and should experience slight discomfort. Most women report zero scarring on their breasts and minor pain. However, some patients are highly sensitive to the biopsy procedure. These include patients with dense tissues or abnormalities behind their nipples or close to their chest wall.
A few women report that the main discomfort they experience from this procedure comes from lying face down throughout the process. Strategically positioned cushions can elevate this discomfort. A few women also experience back or neck pain since the head turns sideways when the physician positions the breasts for the biopsy procedure.
When you are injected with a local anesthetic to numb the skin, you will experience a pinprick from the needle and a slight stinging sensation from the anesthetic. You are likely to experience little pressure while the physician inserts the needle and samples tissue. This is a usual thing. The place will numb within seconds.
You have to stay very still when the radiologist performs the biopsy and imaging. As the radiologist takes tissue samples, you might hear buzzing sounds or clicks from the device used for sampling. This is also a usual thing. Should you experience bruising and swelling after the biopsy, your health care provider may advise you to use an ice pack or pain relievers. It is normal to experience temporary bruising.
Contact your physician should you experience heat in or around the breast, redness, drainage, bleeding, or excessive swelling. If the radiologist left a marker in the breast, it would not cause any pain, harm, or disfigurement. These markers are compatible with MRI and do not alarm metal detectors.
How the Procedure Works
Unlike CT (computed tomography) and x-ray exams, MRI examinations do not utilize radiation. Rather, radio waves realign hydrogen atoms naturally existing in the body. The realignment will not result in any chemical change in the body tissues. As these atoms go back to their initial alignment, they emit various quantities of energy based on the kind of tissue they are located in. The MRI scanner captures this energy and forms a picture utilizing this info.
The powerful magnetic field in most MRI machines is generated by passing electric current via wire coils. Other coils are in the MRI unit, and in certain instances, are put around the body party being imaged. The coils receive and send radio waves, generating signals that the machine detects. Usually, the electric current makes no contact with the person undergoing scanning.
A computer then processes the generated signals and forms several images of thin body slices. The radiologist studies these pictures from various angles. An MRI exam can usually differentiate between normal and diseased tissue much better than ultrasound, CT, and x-ray.
Using MRI guidance to determine where the abnormal tissue is located and verify needle placement, the radiologist inserts the biopsy needle through the skin, moves it further into the lesion, and extracts tissue samples. In case of a surgical biopsy, MRI helps guide a wire into the abnormality to assist the surgeon in locating the area for excision.
After The Procedure
After an MRI-guided breast biopsy procedure, you will have to put on a supportive bra. Additionally, maintain the cleanliness and dryness of the gauze dressing covering your incision for the initial twenty-four to forty-eight hours. You might have to place ice over the biopsy area after the procedure. Your physician will explain more comprehensive post-biopsy care measures for you.
Avoid strenuous tasks for a minimum of forty-eight hours following your biopsy, particularly activities involving the repeated moving of the arms and chest, such as exercising, swimming, vacuuming, and lifting.
When and How You Will Receive the Results
The tissue samples gathered during the biopsy procedure will be taken in a lab for a pathologist to examine and make a diagnosis. After the lab provides the results, which could take three to five business days, a final findings report will be given to your doctor. The doctor will interpret the findings and address all of your questions. The radiologist also reviews the biopsy results to ensure the image findings and pathology match.
At times, even if your doctor does not diagnose breast cancer, they may recommend surgical extraction of the whole imaging abnormality and biopsy site if the image findings and the pathology are not a match.
Follow-up tests may be necessary. If they are, your physician will tell you why. At times, follow-up exams further evaluate possible issues with different views. They may also reveal if there have been any changes in a problem over time. A follow-up exam is usually the best method of seeing if treatment has worked or an issue needs attention.
Find an MRI Clinic Near Me
At Los Angeles Diagnostics, we help patients detect breast abnormalities on time for early treatment solutions. We do this through various exams, such as MRI-guided breast biopsy. Using the latest diagnostic technology, our radiologists are experts at finding abnormalities in the breast that can be cancerous so that you can start treatment right away. Our services are affordable, comfortable, and professional. If you need to undergo an MRI-guided breast biopsy, do not hesitate to call us at 323-486-7502 for a consultation.
