What is Breast MRI?

Breast MRI (magnetic resonance imaging) uses magnets and radio waves to produce detailed 3D images of the breast tissue. The most common breast MRI tests take about 25 to 45 minutes to complete.

Breast MRI can find some breast cancers that would not be detected on a mammogram, particularly in women with dense breast tissue. When breast MRI is used for breast cancer screening, it’s usually used in addition to — not instead of — a mammogram.

Fast (or abbreviated) breast MRI is different from a conventional breast MRI. It may be used as a supplemental test to screen for breast cancer in women who have dense breast tissue or sometimes in those who have other factors that put them at higher-than-average risk of breast cancer.

The test captures fewer images than conventional breast MRI and takes a fraction of the time (about 7 to 20 minutes), but this breast MRI is not yet available at all breast imaging centers. It’s usually not covered by insurance and can cost $300 to $500. Sometimes people opt to get a fast breast MRI as a screening test as a way to save on out-of-pocket costs when their insurance won’t fully cover a conventional breast MRI.

There are several reasons why your doctor might recommend a breast MRI for you:

To find out the extent of breast cancer. After a breast cancer diagnosis, breast MRI may be used to help determine the size and location of the tumor and check for any additional tumors in the breasts. Breast MRI is also used to determine if cancer has spread to the chest wall or to lymph nodes in the armpit. 

To find out how well chemotherapy is working. When chemotherapy is given before breast cancer surgery (this approach is known as “neoadjuvant chemotherapy”), breast MRIs may be used to see how well the chemotherapy is working to shrink the tumor. One breast MRI test may be done at the start of chemotherapy and one may be done in the middle or at the end of chemotherapy treatment.

To screen for breast cancer. If you have a higher-than-average lifetime risk of breast cancer, have dense breast tissue, or you had a diagnosis of breast cancer before the age of 50, your doctor may recommend a regular breast MRI screening. This would be in addition to your annual mammogram.

To gather more information about something that looks unusual in the breast. Doctors sometimes use breast MRI to further examine an area of suspicion seen on a mammogram or ultrasound and help decide if a biopsy is needed.

To guide the needle during a biopsy procedure. A biopsy is the only way to know for sure if a suspicious area of breast tissue contains cancer. Breast MRI may be used to guide the positioning of the needle during a biopsy of the breast. (Note that doctors don't always use the same type of breast imaging for the biopsy that was used to initially detect the suspicious area in the breast. For example, sometimes a suspicious area is detected using breast MRI and ultrasound is used to guide the biopsy needle).

To check if silicone gel-filled breast implants have ruptured. If you have silicone gel-filled breast implants, the U.S. Food and Drug Administration (FDA) recommends periodic imaging with breast ultrasound or breast MRI to check if the implants have ruptured. The first MRI or ultrasound should take place five to six years after the initial implant surgery and then every two to three years after that.  

Breast MRI is also recommended for those who have symptoms of implant rupture or who have had a breast ultrasound that didn’t clearly show whether or not the implants have ruptured. Contrast dye is not used during the test if the only reason you’re getting the MRI is to check for implant rupture.

If you’ve been diagnosed with breast cancer, there may be situations in which your doctor recommends MRI scans of other parts of the body besides the breasts. For example, if you have any symptoms of metastatic breast cancer (breast cancer that has spread to other areas of the body) or if you’ve been diagnosed with metastatic breast cancer, your doctor may recommend an MRI scan of the brain, spine, or bones.

Conventional breast MRI and fast (or abbreviated) breast MRI follow the same steps:

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   You will be asked to remove your clothing and change into pants that don’t have any zippers or other metal and a gown that opens in the front. You will also be asked to remove anything metal you may be wearing.  

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   A contrast solution (dye) will be injected into a vein in your arm or hand through an IV (intravenous line).

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   During the test, you’ll lie face down on your stomach on a padded platform that has cushioned openings for your breasts. Your breasts hang down through the openings in the platform and are not compressed. Each opening is surrounded by a breast coil, which is a signal receiver that detects magnetic signals from the MRI machine.

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   The platform slides into the center of the large, tube-shaped MRI machine. You’ll need to stay very still. You won’t feel anything, but you’ll hear loud noises from the MRI machine. Earplugs or headphones will usually be provided to block the sound. You may be able to listen to music on the headphones if you’d like.

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   The technologist or radiologist will be monitoring you from another room. They may ask you to hold your breath for a few seconds or keep extra still during some parts of the test. You’ll be able to talk to them through a special microphone.

When you schedule your breast MRI, the imaging center staff will tell you how to prepare.

They should let you know whether you should eat, drink, and take your medications as usual on the day of the test.

Make sure you have an order (prescription) from your doctor for the breast MRI and that you’re providing the imaging center with the names and contact info for all the doctors who should receive your test results.

Also, tell your doctor and/or the imaging center staff if:

You have any implanted medical devices or other metal objects in your body. In some cases, you may not be able to safely have an MRI if you have certain types of devices (including some breast tissue expanders) or certain metals in your body. 

You have ever had an allergic reaction to the injectable contrast solution that is used during most breast MRI tests. The contrast solution can also cause complications in some people who have kidney or liver problems.

You’re scared of enclosed spaces (claustrophobia), have anxiety, or find it especially uncomfortable to lie still on your chest. You may want to ask your doctor ahead of time for prescription medication (such as anti-anxiety medication) that could help you feel more comfortable during the test. Plan for someone to drive you home if you are taking medication that could make you sleepy.

You’re pregnant. Usually MRIs aren’t recommended during pregnancy (particularly during the first trimester) due to concerns that the contrast dye might pose risks to the fetus. Learn more about breast imaging during pregnancy. 

You’re breastfeeding. In the past, women were sometimes advised to stop breastfeeding temporarily when they got a breast MRI. More recent studies suggest this may not be necessary because the amount of contrast dye that is excreted into the breast milk is so small that it doesn’t pose a risk to the baby. If you’re breastfeeding, ask your doctor if they recommend that you pump and discard your milk right after the test.  

Depending on where you live, you may be able to get a breast MRI at a local hospital radiology department, breast center, or outpatient imaging center. Usually, the doctor who is recommending that you have a breast MRI will suggest a center to have the test done. It’s important to have breast MRI done at a facility with: 

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  MRI equipment designed specifically for imaging the breasts (called "an MRI machine with dedicated breast coils"). Not all hospitals and imaging centers have this.

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  Accreditation by the American College of Radiology (ACR). This means that the radiologists and technologists are specially trained and certified and that the equipment meets standards and is inspected regularly. Find an ACR accredited facility in your area. 

If you have claustrophobia or a larger body, you may be able to have your breast MRI done in a facility that has a traditional breast MRI machine with a larger opening (a “wide bore” MRI scanner). Before you schedule a breast MRI, talk with your health care team about your options and any concerns you have. Note that “open” MRI machines are not considered effective for breast imaging purposes.

Compared with mammograms and with breast ultrasound, breast MRI is a more expensive test to perform and is not available at as many healthcare facilities.

It’s a good idea to contact your health insurance company before you have a breast MRI and ask if the test is covered and if you’ll have any out-of-pocket costs (such as a deductible, co-pay, or co-insurance). Also, ask if the insurance company needs to authorize the test beforehand for it to be covered.  

Insurance coverage of breast MRI varies a lot. It can be an expensive test if you have to pay some or all of the cost out-of-pocket. (Your out-of-pocket costs might range from about $300 to more than $1,000 if your insurance doesn’t fully cover the test or you don’t have insurance). If your insurance company is initially saying they won’t cover your breast MRI, you and your doctor may want to make the case for them to cover it.

DenseBreast-info.org is a good resource for finding out if the state you live in has any laws requiring insurance companies to cover supplemental breast cancer screening tests.

If your income is low and you are uninsured or underinsured may qualify for  free or low-cost breast MRIs for screening or diagnosis through the Centers for Disease Control and Prevention (CDC)’s National Breast and Cervical Cancer Early Detection Program.

A radiologist (a doctor who specializes in interpreting medical images) will analyze the images from your breast MRI. The radiologist will send the images and a written report about the results to the doctor who ordered the test. In most cases, the doctor who ordered the test will be the one who shares and discusses the results and any next steps with you. But sometimes it will be the radiologist.

You should also receive the written report by mail and/or through a patient portal. If you want a copy of the images, you can request to have them given to you on a CD. 

Radiologists use a system called the Breast Imaging Reporting and Database System, or BI-RADS, to report what they find on a breast MRI, mammogram, or an ultrasound. You may not see these scores, but the written report of your breast MRI results that is sent to the doctor always includes them.