Diseases of the female breast are not a rare clinical picture, they range from inflammation to benign lumps to cancer (e.g. breast cancer) and can affect all age groups. However, breast cancer can also occur in men. In order to be able to quickly recognize dangerous clinical pictures and to classify them correctly, comprehensive diagnostics with imaging of the affected tissue is important. One of the most modern and gentle procedures is the MRI examination of the breast.
MRI – abbreviated for magnetic resonance imaging – is an imaging method that, as the name suggests, works with magnetic fields. There is no exposure to radiation, as in X-rays, mammography or computed tomography (CT). In MRI, the physical properties of water molecules are used in such a way that different tissues present themselves differently according to their water content. This means that soft tissue, which contains more water than bone, can be examined particularly well with this procedure. These include cartilage or ligaments, for example, and also the female breast.
1. use of the MRI ́s in early detection The standard procedure for detecting changes in the breast is usually mammography. As a rule, an ultrasound of the breast is also used. In some cases, however, these methods are not sufficient to make a clear statement about the condition of the tissue.
If you compare the procedure, mammography involves the entire breast being X-rayed at once, so to speak, you only get a shadow. MRI, on the other hand, involves the creation of individual layers in a cross-section, which allows a much better insight into the tissue of the breast and also allows statements to be made about the exact location of changes. In a young woman, whose breasts often still consist of quite dense glandular tissue, it may be difficult to obtain a meaningful image with mammography.
In such a case, an MRI of the breast is indicated (technical term: breast MRI). Women who have a family history of breast cancer or who have even been diagnosed with a hereditary predisposition (the so-called breast cancer gene BRCA-1 or -2) are predestined for examination and diagnosis by MRI. In this risk group, regular early detection examinations by means of imaging are carried out from the age of 25 or 30 (and not from the age of 50, as is usually the case).
If a procedure that uses radiation were to be used so early and regularly, this would also increase the risk of developing breast cancer. Even benign changes can sometimes become the basis for cancer. They must also be monitored regularly.
An MRI examination of the breast thus reduces additional radiation exposure and lowers the risk of degeneration. Another reason for MRI may be the presence of breast implants. Due to the silicone pads, changes in the image may not be visible during a mammography.
2nd application in the follow-up of breast cancer If breast cancer has already been diagnosed, the MRI of the breast can be used for follow-up. Very small foci of 4-5mm and larger, which are not visible in mammography, can be detected and clarified by MRI. The exact extent of the tumor is also often difficult to assess in mammography and ultrasound, since only calcifying tumor parts are visible and growth within the glandular ducts cannot be assessed. MRI provides much more precise images for this purpose and should be a pioneering procedure before surgery in order to be able to remove the cancer completely. During chemotherapy, MRI can be used to assess the regression of the tumor, and once the treatment is complete, it is possible to distinguish between remaining scar tissue or a possibly newly developing tumor.