At Salinas Valley Imaging, we offer breast MRI and MRI-guided biopsy. Salinas Valley Imaging is the only center in the area to utilize the Siemens MAGNETOM Espree Open-Bore 1.5T MRI and Sentinelle breast coil for breast MRI and MRI-guided biopsy. The facility’s breast MRI program is headed by Dr. Amy Lantis Stemerman, Director of the Nancy Ausonio Mammography Center and partner at Salinas Valley Radiologists. Dr. Lantis Stemerman completed her fellowship training in body and musculoskeletal MRI with special emphasis on breast imaging and MRI-guided biopsy. The imaging center’s breast MRI program is fully accredited by the American College of Radiology (ACR).
If you are scheduled for a breast MRI, you will lay facedown on top of our Sentinelle breast coil. Our practice utilizes the Sentinelle Vanguard breast MRI coil system, designed with ergonomics to accommodate patients of all sizes. This technology allows us to customize the coils for each patient, ensuring patient comfort but also optimal imaging.
For more information on breast MRI please call 831-775-5200 to speak with a medical professional.
Magnetic resonance imaging (MRI) of the breast uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the breast. It is primarily used as a supplemental tool to breast screening with mammography or ultrasound. It may be used to screen women at high risk for breast cancer, evaluate the extent of cancer following diagnosis, or further evaluate abnormalities seen on mammography. Breast MRI does not use ionizing radiation, and it is the best method for determining whether silicone breast implants have ruptured.
Breast MRI is not recommended as a routine screening tool for all women. It is, however, recommended for screening women who are at a high risk for cancer, due to strong family history and/or a mutation in genes such as BRCA1 or BRCA2. If a patient is considered high-risk, they would have breast MRI in addition to annual mammograms.
Yearly mammograms with the addition of breast MRI screening are typically recommended for women who are at higher-than-average risk of developing breast cancer, or at greater than the average 13% risk most women have over the course of a lifetime.
The American Cancer Society (ACS) recommends that all high-risk women, those with a greater than 20% lifetime risk of breast cancer, have a breast MRI and a mammogram every year. For most women, these combined screenings should start at age 30, and should continue as long as the patient is in good health. According to the ACS guidelines, high-risk women include those who:
- Have a known BRCA1 or BRCA2 gene mutation
- Have a first-degree relative (mother, father, brother, sister, child) with a BRCA1 or BRCA2 gene mutation and have not had genetic testing themselves
- find out they have a lifetime risk of breast cancer of 20-25% or greater, according to risk assessment tools that are based mainly on family history
- had radiation therapy to the chest for another type of cancer, such as Hodgkin’s disease, when they were between the ages of 10 and 30 years
- have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives.
The American Cancer Society also recommends that women at moderately increased risk of breast cancer, those with a 15-20% lifetime risk, talk with their doctors about the possibility of adding breast MRI screening to their yearly mammogram. According to ACS guidelines, this includes women who:
- find out they have a lifetime risk of breast cancer of 15-20%, according to risk assessment tools based mainly on family history
- have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), or abnormal breast cell changes such as atypical ductal hyperplasia or atypical lobular hyperplasia
- have extremely dense breasts or unevenly dense breasts when viewed by mammograms
If you think you’re a candidate for breast MRI screening, talk to your doctor. You and your doctor may need to work with your health insurance plan to get the test covered.
Breast MRI is not recommended as a screening tool for women who are at average risk of developing breast cancer. Yes, breast MRI has been found to be more sensitive in detecting cancers than mammograms, which does seem like an advantage. However, a major disadvantage is that breast MRI screening results in more false positives — in other words, the test finds something that initially looks suspicious but turns out not to be cancer. If breast MRI were adopted as a screening tool for everyone, many women would end up having unnecessary biopsies and other tests, not to mention the anxiety and distress. That is why current recommendations reserve breast MRI screening for high-risk women only.
MRI examinations may be performed on outpatients or inpatients. You will be positioned on the moveable examination table. Straps and bolsters may be used to help you stay still and maintain the correct position during imaging.
For an MRI of the breast, you will lie face down on a platform specially designed for the procedure. The platform has openings to accommodate your breasts and allow them to be imaged without compression. The electronics needed to capture the MRI image are actually built into the platform. It is important to remain very still throughout the exam. This is best accomplished by making sure you are comfortable and can relax rather than trying to actively hold still tensing your muscles. Be sure to let the technologist know if something is uncomfortable, since discomfort increases the chance that you will feel the need to move during the exam.
If MRI of the breast is being performed for the sole purpose of determining if you have a ruptured breast implant, you will not be given contrast material. If the exam is being performed for any other reason, you will need to have a contrast material injected intravenously. MRI of the breast without contrast material is inadequate for identifying breast cancers.
If a contrast material will be used in the MRI exam, a physician, nurse or technologist will insert an intravenous (IV) catheter, also known as an IV line, into a vein in your hand or arm. A saline solution may be used to inject the contrast material. The solution will drip through the IV to prevent blockage of the IV catheter until the contrast material is injected.
You will be placed into the magnet of the MRI unit and the radiologist and technologist will perform the examination while working at a computer outside of the room.
If a contrast material is used during the examination, it will be injected into the intravenous line (IV) after an initial series of scans. Additional series of images will be taken during or following the injection.
When the examination is complete, you may be asked to wait until the technologist or radiologist checks the images in case additional images are needed, and then your intravenous line will be removed.
MRI exams generally include multiple runs (sequences), some of which may last several minutes. The imaging session lasts between 30 minutes and one hour and the total examination is usually completed within an hour and a half.
Most MRI exams are painless. However, some patients find it uncomfortable to remain still during MR imaging. Others experience a sense of being closed-in (claustrophobia). Therefore, sedation can be arranged for those patients who anticipate anxiety, but fewer than one in 20 require medication.
It is normal for the area of your body being imaged to feel slightly warm, but if it bothers you, notify the radiologist or technologist. It is important that you remain perfectly still while the images are being recorded, which is typically only a few seconds to a few minutes at a time. For some types of exams, you may be asked to hold your breath. You will know when images are being recorded because you will hear tapping or thumping sounds when the coils that generate the radiofrequency pulses are activated. You will be able to relax between imaging sequences, but will be asked to maintain your position as much as possible.
You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centers allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.
You may be offered or you may request earplugs to reduce the noise of the MRI scanner, which produces loud thumping and humming noises during imaging. MRI scanners are air-conditioned and well-lit. Some scanners have music to help you pass the time.
When the contrast material is injected, it is normal to feel coolness and a flushing sensation for a minute or two. The intravenous needle may cause you some discomfort when it is inserted and once it is removed, you may experience some bruising. There is also a very small chance of irritation of your skin at the site of the IV tube insertion.
If you have not been sedated, no recovery period is necessary. You may resume your usual activities and normal diet immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local pain. Very rarely, patients are allergic to the contrast material and experience hives, itchy eyes or other reactions. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.
The Breast Imaging Center of Excellence (BICOE) designation is awarded to breast imaging centers that achieve excellence by seeking and earning accreditation in all of the ACR’s voluntary breast-imaging accreditation programs and modules, in addition to the mandatory Mammography Accreditation Program.
Salinas Valley Imaging Center– Open MRI
559 Abbott St.
Salinas, Ca 93901