What can a breast MRI examine?

Who needs to undergo MRI examination for breast etiology? The scope of MRI examination is very wide. You can also try MRI examination for breast diseases. Today, I will tell you about the effect of magnetic resonance imaging on breast diseases. Let’s take a look.

What is Magnetic Resonance?

Magnetic resonance imaging (MRI) has been widely used in clinical medicine in recent years, but it has not been popularized in medical service enterprises below the county level. MRI images and CT (computed tomography) images have similarities, but they are not exactly the same. The principles of the two are different. MRI uses the principle of using the resonance of atoms in an electromagnetic field to produce magnetic resonance signals to measure the density differences of moving protons in tissues; CT uses X-rays to measure the density differences caused by the attenuation coefficient of radiation when passing through various tissues. The relative density of various tissues in the human body is not very different, so ordinary X-rays cannot distinguish them. The relative density screen resolution of CT is 10 to 20 times higher than that of general X-ray examinations. It is not affected by adjacent anatomical structures and can observe diseases with a diameter of about one centimeter in the body.

Let’s discuss the role of MRI examination of breast diseases.

The efficacy of MRI examination of breast diseases

A disease that cannot be diagnosed by X-ray and B-ultrasound examinations. When the results of mammogram or ultrasound are unclear and cannot be diagnosed, the use of MRI can provide a lot of information and provide strong direct evidence for the diagnosis.

Detect potential breast cancer. Some breast cancers only manifest as swollen axillary lymph nodes, and routine clinical physical examinations and X-rays cannot detect the disease. At this time, a breast MRI examination can often detect a smaller primary lesion.

A woman who had cosmetic surgery to enlarge her breasts. The implants inserted during breast augmentation surgery have the possibility of leaking and cracking. According to surveys, the length of time this happens varies, with the average being 12 years overseas and 8 years for implants in China. About half of the patients have no obvious clinical symptoms. Therefore, for those who have had the prosthesis in place for a longer time, it is recommended to undergo an MRI examination, which can often detect prosthesis dehiscence in the early stages and can be properly treated. For breasts that have undergone breast augmentation surgery with implants, the breasts will be compressed during X-ray examination, which may lead to secondary rupture of the implant and external diffusion of the gel. In addition, due to the obstruction of the embedded implant, X-ray examinations are difficult to show information about the disease. However, MRI examinations do not have this problem. They can effectively display diseases and make a diagnosis. Therefore, if any abnormal lumps are found during palpation after breast augmentation surgery, an MRI examination should be performed.

Patients preparing for breast-conserving surgery. The significance of breast-conserving treatment is to completely remove the tumor while maintaining a satisfactory breast appearance. Multiple studies over the past 30 years internationally have shown that for strictly selected cases, the long-term survival effect of breast-conserving treatment is equivalent to that of total mastectomy. However, basic mammography and B-ultrasound often underestimate the scope of the tumor, and incompletely display multi-center and multi-location diseases. After an MRI examination, other diseases may be found in other locations of the breast. For such patients, total mastectomy should be performed instead of breast-conserving surgery. Research in the UK shows that approximately 40% of patients who undergo breast-conserving surgery suffer partial seizures because they underestimate the scope of surgery. Therefore, for patients suspected of breast cancer by mammography, or patients diagnosed with breast cancer by puncture biopsy, if they want to preserve their breasts, it is recommended to undergo a breast MRI before surgery.

Screening of key targets. Using MRI to screen key subjects is easier to detect abnormal diseases than other imaging diagnostic tests, and can ensure early diagnosis and early treatment. The key targets for breast cancer are defined as: patients with a history of breast cancer; family members with a history of breast cancer; patients with BRCA gene mutations; patients who have undergone breast puncture biopsy and pathologically confirmed intestinal metaplasia; patients with lobular carcinoma in situ; patients with radial scars; and patients who have undergone cloak field chemoradiotherapy for lymphoma.

Comments on the response to neoadjuvant chemotherapy for breast cancer. Traditional postoperative adjuvant radiotherapy is extremely one-sided and cannot achieve the purpose of treatment because its efficacy cannot be predicted. Neoadjuvant chemotherapy is carried out before surgical treatment to carefully observe the disease's response to treatment and determine whether the treatment plan is effective. Chemotherapy can cause breast fibrosis, which reduces the sensitivity of clinical palpation and mammography. MRI can be used to identify chemotherapy response based on the decrease in disease progression, and this method has a high sensitivity for detecting post-radiotherapy reactions.

The above is the effect of magnetic resonance imaging on breast diseases, please pay great attention to it.