Mankato Clinic, in collaboration with The Orthopaedic and Fracture Clinic (OFC), have begun providing patients in the Mankato area with the most state-of-the-art breast imaging services and cancer detection care by offering 3T Breast Magnetic Resonance Imaging (MRI), which is unsurpassed in the region. The new, high-quality breast imaging service is a non-invasive procedure used to evaluate breast problems, primarily to diagnosis breast cancer, by using powerful magnets and radio waves to generate computer images of the breast.

“Mankato Clinic and OFC’s collaboration to bring 3T Breast MRI to Mankato truly offers patients the best in breast imaging,” said Julie Johnson, supervisor of MRI at OFC. “We are striving to meet patient expectations by providing a comfortable environment that brings together the technology, imaging skills, expertise, responsiveness and excellent care that physicians require and patients deserve.”

Used in conjunction with mammography and ultrasound, breast MRI is fast becoming a powerful tool in the detection, diagnosis and management of breast cancer in select patient populations. Breast MRIs are more sensitive than traditional mammograms which use low dosage x-rays to image breasts. Breast MRI is generally used as a complement to diagnostic mammography and is not a replacement for traditional mammography screening.

American Cancer Society guidelines recommend breast MRI, in addition to mammograms, for women at high risk including:

• A strong family history of breast cancer including a mother, sibling or child
• A diagnosis with the BRCA1 or BRCA2 genetic mutation which gives them a 60 – 85 percent lifetime risk of acquiring breast cancer
• A previous diagnosis of breast cancer in one breast by mammography or ultrasound
• Radiation to the chest between the ages of 10 and 30
• Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalca syndrome or may have a close family history of one of these diseases in a first-degree relative

“Breast MRI is not recommended for routine screening or as a replacement for mammography, but is an important tool in clarifying inconclusive findings from a previous mammogram or ultrasound,” said Dr. Maureen Magut, radiologist at Mankato Clinic. “It is commonly used to evaluate for surgical planning because nearly five percent of women with breast cancer in one breast develop a new tumor in the opposite breast, even though nothing is found on a mammogram or physical breast exam at the time of original diagnosis. Finding these cancers earlier may help women make treatment decisions and may spare them from additional rounds of chemotherapy or radiation in the future.”

Because of its high sensitivity, breast MRI is useful in imaging dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.

MRI is also an effective tool for imaging the augmented breast, including the breast implant itself and the breast tissue surrounding the implant which may be obscured by the implant on a mammogram.

It is useful for staging breast cancer, determining the most appropriate cancer treatment and for patient follow-up after breast cancer treatment. MRI may be useful in determining whether breast cancer has spread into the chest wall which often requires the patient to undergo chemotherapy before breast cancer surgery.

In addition to its superior diagnostic ability, researchers have been investigating whether breast MRI may be useful in screening younger women at high risk of breast cancer. Most women under 40 do not require any breast imaging. However, the American Cancer Society recently recommended that women at very high risk of developing breast cancer have annual breast MRI exams in addition to annual mammograms to increase the likelihood that breast cancer will be detected early, when the chances of survival are greatest.

The most useful MRI technique uses a contrast material called Gadolinium DTPA, which is injected into a vein in the arm during the exam to improve the quality of the images. This contrast agent helps produce a stronger and clearer image and highlights any abnormalities.

During a Breast MRI, a patient lies face down on an exam table, keeping still and breathing normally. A physician may prescribe a mild oral sedative to help the patient rest comfortably in the scanner and reduce any feeling of claustrophobia. Unlike mammography, the breasts are not compressed during the exam so there is no discomfort. The table then moves into a cylinder shaped machine with the magnet where the images are taken. The test does not use any harmful or dangerous radiation. The exam is performed at OFC and a Mankato Clinic radiologist interprets the images and sends a report to patient’s ordering physician.

“Because patients in Mankato can now receive the best in breast imaging care here at home, it is more convenient for the patient and her physician,” said Dr. Magut. “This allows for better coordinated care between a woman and her healthcare team.”

3 Tesla (T) MRI is the best in breast MRI imaging because of the strength of its magnet, a 3 Tesla, which is twice the strength of the more commonly available 1.5 Tesla. The magnetic field produced by the 3T yields exceptional anatomic detail and offers higher signal to noise ratio, better image resolution and faster scan times. It is the highest strength scanner currently available in the Mankato area.

“3T breast MRIs have been shown to improve patient outcomes due to its high sensitivity magnet,” said Dr. Magut. “MRI, coupled with mammography, detects almost all cancers at an early stage; therefore, a smaller size, which reduces the incidence of advanced stage breast cancer in high-risk patients.”

This system, with its 70 cm Open Bore, is one of the largest scanners available being at least 10cm wider than the average scanner. It is made for patients of all shapes and sizes and improves patient comfort and reduces incidents of anxiety and claustrophobia.

To find out more about breast MRI, contact a breast health nurse at Mankato Clinic at 507-389-8781.