Breast Magnetic Resonance Imaging (MRI) Patient Information Sheet Patient Information Incorporating hospital and community health services, teaching and research Breast Team Cancer Services Homerton University Hospital NHS Foundation Trust Homerton Row E9 6SR Reviewed 2012 Next date October 2014
What is an MRI of the breast? MRI stands for Magnetic Resonance Imaging. An MRI scan is an investigation that produces pictures of the inside of the body or part of the body such as the breast. The machine which takes the pictures is a large tube shaped magnet about four feet long, linked to an advanced computer. The whole body passes through the tube even if only one part of it is being scanned. Unlike an x-ray, an MRI does not use radiation therefore it is safe. An MRI of the breast produces detailed images of the breast from side to side, top to bottom, and front to back. These images are then interpreted by the radiologist. Why is a Breast MRI used? 2 An investigation of your breasts to detect or provide more information about an abnormality To assess accurate size or the extent of the tumour To assess whether there is more than one tumour To monitor and check tumour shrinkage during chemotherapy treatment In general younger women have dense breast tissue which does not allow abnormalities to show clearly on mammogram and ultrasound To investigate breast abnormalities that can be felt but are not seen on:- 1. Mammogram 2. Ultrasound scan 3. After breast surgery
4. After radiotherapy 5. After chemotherapy 6. To evaluate breast implants for leaks or ruptures MRI scans along with ultrasound and mammograms can detect cancers early, when they are very small and easier to treat. MRI is better at finding multiple tumour locations in the same breast. Mammography is better at finding small calcifications that are linked with non-invasive cancers. This means that both types of investigations are useful. Breast MRI is not used for routine breast cancer screening. Clinical trials (research studies) are being performed to see if MRI would be valuable for screening certain women, such as young women with a high risk of breast cancer. MRI cannot always accurately distinguish between cancer and non-cancerous breast conditions. Where is MRI scan performed? Breast MRI is a specialised investigation; we offer this service at Homerton University Hospital. You will receive details of your scan appointment by letter or by phone. MRI at Homerton Hospital is performed in X-ray 1 situated on the main corridor of the hospital. Occasionally we may have to refer you to St. Bartholomew s Hospital NHS Trust for this investigation. You will receive your MRI scan appointment from them along with details of how to find the X-ray (radiology) department. 3
The scan is done as an outpatient procedure, which means that you can go home immediately after your investigation. Who cannot have an MRI Scan? In most cases, an MRI exam is safe with metal implants, however in some cases it may not be possible to have this investigation done if you have the following: a pacemaker, artificial limb, any metal pins or metal fragments in your body (especially in the eyes) like heart valves, clips in your brain, implants in your ear, tattooed eyeliner or metallic-based tattoos, or any other implanted or prosthetic medical device (such as a medication infusion pump). inform your health professional if you have worked around metal or if you have recently had surgery on a blood vessel You are pregnant or breast feeding unless there are special circumstances if you have a known allergy to the contrast (dye) used for MRI Any other health conditions like serious kidney problems or sickle cell anaemia that may prevent you from having an MRI using contrast material. any body jewellery that cannot be removed or nail extensions with metal decorations Inform and seek the advice of your health professional and radiographer. What happens when I arrive? On arrival you will be shown to a private cubicle to get undressed and put on a gown provided by the 4
hospital. You will have to remove all jewellery or any other metallic items, preferably before you come for your investigation. The hospital is not responsible for loss of any valuables. Who will I see? You will be looked after by a small team including a radiologist and radiographer who will perform the examination. If you have any questions you can ask them. What happens during the MRI scan? You will be taken into a special room and made comfortable on the table. During an MRI of the breast, you will be asked to lie on your stomach on the scanning table. Breast MRI Machine The breasts are placed into the specially designed hollows in the table, which contains coils that detect the magnetic signal. The coils do not cause any discomfort to the breast. The table is then moved into the magnetic tube for the scan to take place. 5
When you first arrive the technician may insert a needle into a vein (IV line) in your arm. The purpose for this is to allow a contrast agent (dye) to be injected during the scan. After taking a number of images (pictures, scans), you may feel the technician injecting the contrast agent through the needle before taking more images. This may cause a warm feeling for a short while. The contrast agent not radioactive and helps improve the quality of the pictures. During the test the radiographer monitors you from another room. You will be able to communicate with the radiographer through an intercom. You will be asked to breathe normally but it is important to keep still avoiding any motion artefacts (artefacts: shows up on the scanner and can affect the image quality). Breast Coil Glide head first The entire imaging session can take up to an hour. Can I bring a relative/friend? Yes, but for the reasons of safety they will not be able to accompany you into the scanning room. They can only accompany the patient in the scanning room under special circumstances. What are the Benefits and Risks? 6
There are no known dangers or side effects connected to an MRI scan (unless you have some types of surgical implant e.g. pacemaker) The test is non invasive and does not cause any pain MRI does not involve the use of x-rays The contrast dye injected into a vein shows detailed features of the breast tissues. Rarely side effects can occur with this contrast (dye). Although the scanner is open at both ends some people find this test claustrophobic. If you are nervous in confined spaces you need to discuss this with your doctor before you come for your scan. We need to know this in advance as you may need medication to help you stay relaxed The machine makes loud thumping noises while it is working, which you might find unpleasant. You will be given ear plugs to wear to help muffle the noise or you may be able to have music or the radio played through the intercom. You will be asked to sign a consent form saying you understand the MRI investigation and agreed to have the test done. When will I know the results? The radiologist, who is an expert in this field, will interpret these images and prepare a report for your doctor. The results of your MRI will be discussed in your next breast appointment. If for any reason you are unable to attend this appointment or need to change your appointment time, even at a short notice, please inform the 7
appropriate department. This is very important because this appointment can be offered to another patient who is on the waiting list. Please arrive at least 15 minutes early for your appointment. Please bring with you all the medications you are taking. If you need an advocate in your language, please inform the radiology department before you come for your investigation. For further information please contact: Contact at Homerton Hospital MRI Secretaries 020 8510 7375 020 8510 7848 Breast Cancer Nurse: 020 8510 7023 (St. Bartholomew s Hospital) MRI Radiologist Reception: 020 7601 7002 Further Information Health and Cancer Information Centre (Health Shop) The Health Shop is a drop in Health and Cancer Information Centre, based at the main entrance of the hospital. It provides information and support on cancer and cancer related issues. Macmillan Cancer Information Manager: Tel No: 0208 510 5191 Email: madhu.agarwal@homerton.nhs.uk Website: www.homerton.nhs.uk Homerton Hospital PALS (Patients Advice & Liaison Service) PALS is based in the main reception of the hospital. Email: pals@homerton.nhs.uk Tel: 020 8510 7315 (9am 5pm) 8
PALS provides confidential information and support, helping you to sort out any difficulties or concerns you have whilst in hospital, guiding you through the different services from the NHS. Breast Cancer Care Provides information and support to those affected by breast cancer - women and men, their partners, families & friends. Produces a range of booklets and leaflets on Breast Cancer. Kiln House 210 New Kings Road, London SW6 4NZ Helpline: 0808 800 6000 (10am- 5pm Monday to Friday & 10am-2pm Saturdays) Email: info@breastcancer.org.uk Website: www.breastcancercare.org.uk Breakthrough Breast cancer Dedicated to saving lives by finding the causes of breast cancer, improving detection, diagnosis, treatment and services Helpline No: 08080 100 200 Email: info@breakthrough.org.uk Website: http://www.breakthrough.org.uk Macmillan Cancerline Free information and emotional support for people living with cancer. Telephone translation service for those whose first language is not English. 89 Albert Embankment London, SE1 7UQ National Helpline No: 0808 808 2020 Website: www.macmillan.org.uk Related websites NHS Direct Telephone: 0845 4647 www.nhsdirect.nhs.uk http://www.nhs.uk/pages/homepage.apx www.cancerhelp.org.uk 9
www.radiologyinfo.org If English is not your first language or you have problems understanding this leaflet please let a member of staff know. Important information Please remember that this leaflet is intended as general information only. It is not definitive. We aim to make the information as up to date and accurate as possible, but please be warned that it is always subject to change. Please, therefore, always check specific advice on the Hand Hygiene In the interests of our patients the trust is committed to maintaining a clean, safe environment. Hand hygiene is a very important factor in controlling infection. Alcohol gel is widely available throughout our hospitals at the patient bedside for staff to use and also at the entrance of each clinical area for visitors to clean their hands before and after entering. Other formats If you require this leaflet in any other format such as larger print, audio tape, Braille or another language please speak to your clinical nurse specialist (Keyworker) Reference The following team members have been consulted and agreed this patient information: Consultant, Clinical Nurse Specialist (Keyworker), Macmillan Cancer Information and Support Manager and Patient Homerton University Hospital NHS Foundation Trust Tel: 020 8510 5555 Website: www.homerton.nhs.uk Email: enquiries@homerton.nhs.uk 10