Breast Magnetic Resonance Imaging, or breast MRI, uses a magnetic field and radio waves to create 3D images of the breast. A breast MRI is more invasive than mammography because a contrast dye is given through an IV before the procedure, but it gives clearer, more detailed pictures than other imaging tests. A breast MRI can often detect a mass that’s felt during an exam but isn’t visible on a mammogram or a breast ultrasound. It can determine whether a tumor is localized to one spot in the breast, or if it has spread to other locations in the breast or in the chest wall. It can also show if an area is scar tissue or a tumor that has returned. For breast cancer screening, some women who are at higher risk will have a breast MRI in addition to their mammogram. However, for women at average risk, it’s not recommended as a screening tool. Compared to a mammogram alone, combining a mammogram with a breast MRI can help detect breast cancer better in women who are at higher risk. It’s important to know that a breast MRI is a very sensitive test, meaning that many abnormalities may show up. However, it can’t always tell the difference between cancer and a benign breast condition, meaning that false positive results can happen. A false positive is something that looks abnormal but turns out to be benign, or not cancerous. Any abnormal area must be checked with a follow-up test to be sure it’s not breast cancer, which sometimes leads to procedures that aren’t necessary. This is one of the reasons why a breast MRI is not a good screening test for women at average risk. Before a breast MRI, you’ll be asked to undress from the waist up and put on a gown or robe that opens in the front. You’ll be asked to remove any jewelry. You’ll be able to safely store your personal items in a locker. Before the MRI, an IV will be placed for the contrast dye. Then, the technologist will take you to the MRI machine and help you get into the right position. You’ll lie face down on a special table with your breasts positioned into cushioned openings. Let the technologist know if you feel uncomfortable, since you’ll be in the same position for a little while and you’ll need to stay as still as possible while the images are taken. Once you’re in the correct position, the technologist will leave the room, but they will still be able to see you and talk to you throughout the test. Once the test starts, the table will move you slowly into the MRI machine, which often looks like a tunnel. After some of the first images are taken, the contrast dye will be injected into your IV. You may feel a sensation for a little while afterwards. More images will be taken before the test is complete. The test can take about 30 to 60 minutes in total. Once the test is complete, your IV will be taken out and you’ll be able to go home. A radiologist will review the images and put their findings in a report. You’ll receive the results from your health care provider, who will discuss the next steps with you. It’s important that you get your results. If you don’t receive them within 1 to 2 weeks, contact your health care provider or the place where your breast MRI was done. The National Comprehensive Cancer Network, or NCCN, recommends yearly screening with mammography plus a breast MRI for women at higher risk of breast cancer including those with:

• A BRCA1 or BRCA2 inherited gene mutation.
• A first-degree relative, meaning a mother, sister or daughter of a person with a BRCA1 or BRCA2 inherited gene mutation who has not been tested herself.
• A diagnosis of Li-Fraumeni syndrome or Cowden/PTEN syndrome and those who are first-degree relatives of someone with one of these syndromes.
• A PALB2, PTEN, STK11 or TP53 inherited gene mutation.
• A greater than 20% lifetime risk of invasive breast cancer based mainly on family history.
• And people who had radiation treatment to the chest area between ages 10 and 30.

The tests may be spaced out so that a screening test is done every six months. The NCCN also recommends some women talk with their health care provider about getting a breast MRI as part of their breast cancer screening plan, including those with:

• A diagnosis of lobular carcinoma in situ, also known as LCIS and who have a 20% or greater lifetime risk of invasive breast cancer.
• A diagnosis of atypical hyperplasia and a greater than 20% lifetime risk of invasive breast cancer.
• And those with an ATM, BARD1, CDH1, CHEK2, NF1, RAD51C or RAD51D inherited gene mutation.

In addition to there being guidelines for screening in women at higher risk, there are screening recommendations for transgender people at higher risk of breast cancer. The American College of Radiology offers breast cancer screening guidelines for transgender people at higher risk of breast cancer. They’re tailored based on several factors. If you’re transgender, talk with your health care provider about a breast cancer screening plan that’s right for you. The key takeaway is to talk with your health care provider about breast cancer screening. Together, you can decide on a screening plan that’s right for you. For more information, visit the Screening and Early Detection section on komen.org.