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BILATERAL
BREAST MRI
Until there's a cure DIA will lead
the fight. We're armed with Breast MRI.
We fight for our grandmothers,
mothers, sisters, daughters, granddaughters, aunts, cousins, & nieces.
We'll fight for your family too.
Which Diagnostic Imaging Associates location offers Breast MRI?
What is
Breast MRI and how is the procedure done?
Why should I
choose DIA for my Breast MRI exam?
Why is DIA's
Bilateral Breast MRI unique?
What is Computer-Aided Detection (CAD), and how does it enhance breast
MRI?
Why is the gadolinium
necessary?
What are some common
uses of Breast MRI?
Am I a Candidate for Breast
MRI?
I have
breast implants - can I have a Breast MRI?
Clinical Indications for
Breast MRI
Is Breast MRI a
better test than mammography?
Is Breast MRI safe?
What should I wear
to my appointment?
How long does it take?
How should I prepare?
Which Diagnostic Imaging Associates location offers Breast MRI?
DIA's MRI of
Wilmington location is proudly serving the fight against breast cancer,
utilizing state-of-the-art Bilateral Breast MRI. (302) 427-9855 • 1020
N. Union Street • Wilmington, DE 19805.
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What is
Breast MRI and how is the procedure done?
MRI is a
non-invasive method of medical imaging in which the patient’s area of
interest is viewed in extremely thin segments from multiple directions,
providing computer-generated images. The radiologist can then “page
through” the tissue or create a three-dimensional image. No radiation is
involved, and there is no flattening or compression of the breast. The
patient lies face-down on a special table so the breasts are suspended
through an opening into unique “coils” that transmit and receive the
radio frequency signals used in MRI. Once positioned, the patient is
moved feet first into the magnet so he/she can still look to the
outside. DIA's MRI has a large opening to alleviate feelings of
claustrophobia. Earplugs and/or music are provided to diminish the sound
of the MRI. An IV line is established beforehand to allow injection of
the gadolinium contrast.
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Why should I
choose DIA for my Breast MRI exam?
DIA has 25 years
experience in breast imaging (mammography and breast ultrasound) and 5
years of experience in Breast MRI. DIA Board-Certified Radiologists,
Technologists, and specialized equipment offer state-of-the-art MRI
exams. By correlating the patient's Breast MRI with other studies
including Ultrasound and Mammography, we are able to provide the most
accurate diagnosis. DIA's Bilateral Breast MRI technology generates
exceptionally detailed images of breast tissues. It is an extremely
accurate method of disease detection throughout the breast and
surrounding anatomy. DIA's MRI determines the extent of the disease
bilaterally and reveals lymph node involvement. The goal of this
advanced technology is to allow detection of new breast cancers at
earlier stages and enhance the management and care of our patients.
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Why is DIA's
Bilateral Breast MRI unique?
With DIA's
Bilateral Breast MRI, a patient needs only one visit, and one exam.
While DIA has been one of the only facilities in the region providing
MRI of the breast for a number of years, a recent upgrade to GE's
VIBRANT software has allowed for significantly improved resolution and
faster scanning for bilateral breast exams. Contrary to having the study
performed on other MRI scanners – DIA's patient does not require
two exams, and two injections of contrast, on two separate days. DIA
now provides patients with high-definition bilateral breast imaging in
one patient visit – in one exam.
DIA's VIBRANT
technology employs a unique scan procedure that thoroughly analyzes all
parts of the breast tissue within minutes. With absolute confidence, DIA
Radiologists utilize the system's bilateral breast imaging technique
because it is the most sensitive to the patient's diagnostic needs.
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What is Computer-Aided Detection (CAD), and how does it enhance breast
MRI?
Computer-aided-detection (CAD) plays a significant role in improving
quality, efficiency, and standardization in women's imaging programs.
Diagnostic Imaging Associates utilizes CADstream™, the first CAD
application designed exclusively for MRI. CADstream assists DIA
Radiologists in the interpretation and reporting of data-intensive
Breast MRI studies. The system automates image processing functions –
for example, CADstream allows your DIA Radiologist to create thousands
of customized images with the ability to localize lesions with 3D
navigation. The result is more standardized image processing and
analysis, higher quality images and more rapid interpretation of the MRI
study. The use of CAD ultimately makes breast MRI more accessible to
women who would benefit from this valuable study.
CADstream is the
standard in CAD for MRI. The system incorporates the American College
of Radiology's recommendations and the BI-RADS® Atlas (Breast Imaging
Reporting and Data System) for lesion classification. CADstream is the
only CAD for MRI product on the market that incorporates ACR standards.
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Why is the gadolinium
necessary?
Breast cancers have
a rich blood supply, so tumors “light up” on MRI, helping to distinguish
them from normal breast tissue. These are called areas of
“enhancement.” It is the contrast agent, gadolinium that makes Breast
MRI sensitive in cancer detection. When there is no enhancement, the
radiologist can exclude the possibility of a lesion with about 95
percent confidence. Gadolinium is not the same as x-ray dye which
contains iodine, and the likelihood of negative reaction is negligible.
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evaluate abnormalities
detected by mammography.
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identify early breast
cancer not detected through other means, especially in women with dense
breast tissue and those at high risk for the disease.
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screen for cancer in women
who have implants or scar tissue that might jeopardize an accurate
result from a mammogram.
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determine the integrity of
breast implants.
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distinguish between scar
tissue and recurrent tumors.
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assess multiple tumor
locations.
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check the progress of
chemotherapy.
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look for multiple tumors
prior to breast conservation surgery.
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determine whether cancer
detected by mammography or ultrasound has spread further in the breast
or into the chest wall.
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determine how much cancer
has spread beyond the surgical site after a breast biopsy or lumpectomy.
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provide additional
information on a diseased breast to make treatment decisions.
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Anyone (yes, men
too) can have a Breast MRI exam. Clinical studies using Breast MRI have
demonstrated great reliability in detecting invasive breast cancer, with
reported sensitivities approaching 100 percent. If you are at high-risk
for cancer, newly diagnosed with cancer or have undergone treatment for
cancer, talk to your physician about the role of MRI in your care.
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Currently, most Breast MRI
candidates are women who already have a cancer diagnosis and plan to
have surgery or chemotherapy followed by surgery.
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Other candidates are those
with a suspicious lump or mammogram, who are also going on to have a
biopsy or surgery.
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Women may also be
candidates if they have dense breasts, scar tissue from previous breast
surgery or
implants,
which may prevent mammography from providing an adequate picture of the
breast.
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Some Breast MRI studies
include women who are at high risk for breast cancer (due to a previous
cancer diagnosis, strong family history for breast cancer or a positive
test for one of the breast cancer genes).
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I have breast
implants - can I have a Breast MRI?
Yes,
Breast MRI is sometimes used to image silicone breast implants. If you
have breast implants, it is important that you tell the DIA scheduler
prior to your exam. We will also need to know if your implants are
filled with saline, silicone or oil, or a combination of these. In
addition, we need to know if the implant has a polyvinyl chloride sponge
covering. Please get this information from your plastic surgeon’s office
prior to your MRI exam.
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Clinical Indications for Breast MRI
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Lesion Characterization
–
Breast MRI may
be indicated when other imaging examinations, such as ultrasound and
mammography, and physical examination are inconclusive for the presence
of breast cancer. Breast MRI may be helpful in patients who have had
previous surgery for breast cancer, to distinguish between postoperative
scarring and recurrent cancer. Other conditions that may impair
conventional breast imaging, such as silicone augmentation or dense
breasts, may warrant Breast MRI depending on the clinical findings.
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Neoadjuvant Chemotherapy
– Breast MRI may be
employed before, during, and/or after a course of chemotherapy to
evaluate chemotherapeutic response and the extent of residual disease
prior to surgical treatment.
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Infiltrating Lobular
Carcinoma
– Physical
examination, mammography, and ultrasound may be limited in the
evaluation of infiltrating lobular carcinoma. Breast MRI may be
indicated for evaluation of extent, multifocality, and multicentricity.
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Infiltrating Ductal
Carcinoma
– Breast MRI may be
indicated in order to determine the extent of disease, particularly in
breast conservation candidates. MRI determines the extent of disease
more accurately than standard mammography and physical examination in
many patients.
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Axillary Adenopathy,
primary unknown
– MRI may be
indicated in patients presenting with axillary adenopathy and no
mammographic or physical findings of primary breast carcinoma. In
patients with breast cancers, Breast MRI can locate the primary tumor
and define the disease extent for definitive therapy. A negative Breast
MRI may exclude the breast as a potential primary site of cancer and
avoid a mastectomy that would provide no treatment benefit.
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Post-Mastectomy Breast
Reconstruction Evaluation
–
Breast MRI may be indicated in the evaluation of suspected cancer
recurrence in patients with tissue transfer flaps or implants.
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Breast Augmentation
– Breast MRI may be indicated
in the evaluation of patients with silicone implants and/or injections
in whom mammography is difficult, and in patients with non-silicone
implants. In these settings, Breast MRI may be helpful in the diagnosis
of breast cancer and in the evaluation of implant integrity and rupture.
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Invasion Deep To Fascia
– MRI evaluation of breast
carcinoma prior to surgical treatment may be indicated in both
mastectomy and breast conservation candidates.
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Contralateral Breast
Examination In Patients With Breast
Malignancy – MRI can detect unsuspected disease in the
contralateral breast in at least 4% - 5% of breast cancer patients. This
is often in the face of negative findings on mammography and physical
examination.
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Post-Lumpectomy For
Residual Disease
– Breast MRI
may be used in the evaluation of residual disease in patients who have
not had preoperative MRI and whose pathology specimens demonstrate close
or positive margins for residual disease. MRI can evaluate for
multifocality and multicentricity to help determine which patients could
be effectively treated by re-excision or whether a mastectomy is
required due to the presence of more extensive disease.
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Surveillance Of
High-Risk Patients
– Recent
clinical trials have demonstrated that Breast MRI can significantly
improve the detection of cancer that is otherwise clinically and
mammographically occult. Breast MRI may be indicated for women with a
genetic predisposition to breast cancer.
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Recurrence Of Breast
Cancer – Breast MRI may be
indicated in women with a prior history of breast cancer and suspicion
of recurrence when clinical and/or mammographic findings are
inconclusive.
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Is Breast
MRI a better test than mammography?
Breast MRI is not to replace
mammography, which has saved many lives from breast cancer. Instead it
provides a powerful supplementary tool for detecting and staging breast
cancer. The two tests are both great exams, each with their own
strengths. Most commonly, Breast MRI is performed to answer a specific
question raised from the patient’s mammogram. Breast MRI is a more
sensitive test in detecting breast cancer than mammography. There are
some cancers that can be seen with MRI that cannot be seen with
mammography. This is especially true in patients who have dense breast
tissue. Regardless of breast density, if a breast cancer is present,
Breast MRI can detect it greater than 95% of the time, while mammography
can detect cancer approximately 80-90% of the time. If the patient has
dense breast tissue, the rate of detection of cancer can go down to as
low as 50% by mammogram alone. For this reason, Breast MRI can be quite
helpful in this sub-group of patients who have dense breast tissue on
their mammograms and a change in their mammogram, a palpable lump or a
biopsy-proven cancer. (Note: If you have dense breast tissue it is
likely that DIA's Digital Mammography will provide better imaging
quality for you than a conventional mammography).
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If MRI is a more sensitive test than
mammography, can I just have this test instead of a mammogram each year?
No. All Breast MRI’s should be read in
conjunction with the patient’s mammogram. Both mammography and MRI have
different strengths. For example, mammography is better at detecting
very tiny calcifications, which can be an early sign of breast cancer.
Breast MRI is not to replace mammography, which has saved many lives
from breast cancer. Instead it provides a powerful supplementary tool
for detecting and staging breast cancer.
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Is Breast MRI safe?
Yes. MRI examination poses no risk to the average
patient.
People who have had heart surgery and people with the following medical
devices can be safely examined with MRI:
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Surgical clips or sutures
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Artificial joints
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Staples
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Most heart valve replacements
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Disconnected medication pumps
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Vena cava filters
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Brain shunt tubes for hydrocephalus
Some conditions may make an MRI examination inadvisable. Tell your
doctor if you have any of the following conditions:
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Heart pacemaker
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Cerebral aneurysm clip (metal clip on a
blood vessel in the brain)
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Implanted insulin pump (for treatment of
diabetes), narcotics pump (for pain medication), or implanted nerve
stimulators ("TENS") for back pain
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Metal in the eye or eye socket
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Cochlear (ear) implant for hearing
impairment
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Implanted spine stabilization rods
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Severe lung disease
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Uncontrolled gastroesophageal reflux (a
condition causing severe heartburn)
In addition, tell your doctor if you:
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Are pregnant
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Weigh more than 250 pounds (DIA welcomes a
patient site-visit to ascertain if weight will prohibit the study.)
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Are not able to lie on your stomach for 30
to 60 minutes
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Have claustrophobia (fear of closed or
narrow spaces)
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What should I wear to my
appointment?
Please dress comfortably— sweatpants and
sneakers are perfect. It is important to not wear clothes with metal
zippers, buttons or snaps; no metal is allowed in the MRI exam room.
Safety pins, straight pins, metal hair pins and all jewelry must be
removed before entering the room.
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How long does it take?
The average Breast MRI exam takes about
30 to 45 minutes.
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How should I prepare?
There is no pre-exam preparation—you may
eat and drink as you normally would and take medications as you normally
would.
Jewelry and other accessories should be
left at home if possible, or removed prior to the MRI scan. Metal and
electronic objects can interfere with the MRI's magnetic field and are
not allowed in the exam room.
- Jewelry, watches, credit cards and hearing aids, all
of which can be damaged.
- Pins, hairpins, metal zippers and similar metallic
items, which can distort MRI images.
- Removable dental work.
- Pens, pocketknives and eyeglasses.
- In most cases, an MRI exam is safe for patients with
metal implants, except for a few types. (see "Is Breast MRI safe?")
Tell the technologist if you have
medical or electronic devices in your body, such as:
- Artificial heart valves.
- Implanted drug infusion ports.
- Implanted electronic devices.
- Artificial limbs or metallic joint prostheses.
- Implanted nerve stimulators.
- Metal pins, screws, plates or surgical staples.

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