New Technology Improves Breast Cancer Detection and Treatment

By Eric S. Grimm, DO

Breast MRI (magnetic resonance imaging), an innovative and valuable diagnostic tool, is now available at the Woman's Imaging Center at Wellington Regional Medical Center.

It is a non-invasive procedure that captures images from inside the breast without surgery or compression of the breast (as in a mammogram). Each exam produces hundreds of 3-D images that are interpreted by a radiologist.

No radioactivity is involved, and the technique is believed to have no health hazards. Its exquisite sensitivity allows it to capture hard-to-fi nd or smaller images.

MRI has been used for many years to diagnose implant ruptures in breasts and abnormalities in other body parts, but its use is relatively new in diagnosing breast disease. This new MRI technology allows for early detection of small breast cancers, as well as diagnosis of benign abnormalities.

Who Benefi ts From Breast MRI?
Breast MRI can be used as a problem-solver in patients with uncertain mammographic or sonographic abnormalities. In addition, breast MRI is often useful in the following circumstances:

• A patient with a significant family history or genetic predisposition for cancer may undergo MRI to provide more precise evaluation, allowing for the earlier detection and treatment that offer a patient a better prognosis.
• A diagnosed breast cancer patient may undergo MRI prior to surgery. Often, a patient with cancer in one area of the breast may plan to undergo a lumpectomy to preserve the breast. By using MRI to evaluate the other areas of the breast, and opposite breast, additional cancers can be diagnosed at earlier stages, which may affect surgical management.
• MRI is used as a tool to monitor a cancer patient's response to chemotherapy.
• MRI may be used in a patient with enlarged cancerous lymph nodes found in the axilla (armpit) who has not yet been diagnosed with a primary cancer.
• A previous cancer patient who shows signs of an abnormality at the surgical site may also need MRI to detect masses hidden by scar tissue.
• Younger women whose dense breast tissue is difficult to diagnose using other tools may undergo MRI.
• Patients with one-sided bloody nipple discharge may benefit from MRI.
• MRI is also used to evaluate patients with possible silicone implant ruptures.

Figure 1A: contrast-enhanced tumor
Figure 1B: color-enhanced tumor

How MRI Works
Breast MRI detects solid lesions or masses that become more visible after the breast is injected with a contrast solution. These lesions brighten, or enhance, so they are more easily identifi ed (Figure 1A). Advanced breast MRI software programs provide additional tools for the interpreting radiologist, such as color maps (Figure 1B).

During MRI, a patient lies on an MRI table with both breasts hanging freely into a cushion. The cushion (coil) contains the technology that helps capture the MRI signal needed to obtain the image once the table is advanced into the magnetic opening of the MRI machine. The MRI machine takes several 3-D pictures, or scans, that take about fi ve minutes each. In all, MRI usually lasts about 30 minutes.

MRI as Part of
Comprehensive Treatment
Breast MRI is an evolving technology that is currently used under specifi c conditions. It is not a substitute for screening mammography or other valuable diagnostic procedures.

Patients should be aware that MRI, because of its high sensitivity, may capture images of tissue or masses that are not readily identifi able as cancerous or benign. MRI may locate normal tissue, lymph nodes, and benign fi broadenomas and papillomas. In some cases, biopsies must still be performed after MRI to obtain diagnoses.

The Wellington Regional Advantage
Wellington Regional uses advanced technology, including vibrant software, seven channel breast MRI coil and highfi eld MRI to obtain high resolution images for diagnosis. The Woman's Imaging Center at Wellington has the capability to biopsy questionable areas if MRI does not provide a defi nitive picture. Biopsy is performed with a vacuum-assisted device. By performing both imaging and intervention, we are better able to understand and coordinate breast care.

The Woman's Imaging Center is accredited by the American College of Radiology and meets MQSA (Mammography Quality Standards Act) standards. To learn more about breast MRI please call 561-798-8513.

Eric S. Grimm, DO, is a board-certifi ed interventional breast radiologist with cross-sectional imaging fellowship training. Dr. Grimm is a partner of Wellington Imaging Associates along with Drs. Huber, Baumel, Kirchner, Mandel and Ruehrmund.

Wellington Regional Medical Center, 10101 Forest Hill Blvd. Wellington, FL 33414 (561) 798-8500