So Your Doctor Ordered a Breast MRI—What’s Next?
In honor breast cancer awareness month, I want to talk about the breast MRI screening. I am neither a medical professional nor a cancer survivor. This information is based on my experience of getting breast MRI screenings annually for the last five years. Please consult an appropriate medical professional about your personal medical questions or concerns.
Maybe you found a lump in your breast. Maybe you did a screening mammogram, and your doctor thinks an additional screening is necessary. Maybe like me, you have a genetic mutation like BRCA1+ or BRCA2+ that makes you extremely high risk for breast cancer, so you rotate bi-annual screening mammograms and breast MRIs. Whatever the reason, your doctor ordered a breast MRI, and you may be nervous.
There are articles that are good at explaining the basics of a Breast MRI that give important definitions, explanations, and tips such as checking your insurance coverage beforehand, but I’m here to metaphorically hold your hand and walk you through some of the information that’s not always included in these articles.
After your doctor submits the order you will need to schedule your MRI. My primary concern in scheduling is finding a time when I’ll have childcare options as I can’t bring my children to this appointment. I don’t have a gender preference for my technician, but if you have a preference, this is the time to state it. Even without my request, some schedulers have vocalized that they are looking for times when a female technician is available, so I assume it is a common request.
If you are hoping to have a support person come with you or if you’ll need assistance, check COVID protocols early. In pre-COVID days, I’ve seen patients with a support person in the general waiting room and sometimes in the dressing room. This person is not able to go in the MRI room with you.
At the facility you’ll likely have a check-in and registration process, followed by a wait. When you are called back, you’ll be taken to a changing room. You’ll need to remove all clothing from the waist up and any clothing with metal (like pants with a zipper). When I’ve worn leggings without metal, I’ve been allowed to keep those on. You can bring comfortable socks from home to wear to both keep your feet warmer and save you from walking the halls barefoot. You may be given two hospital robes—one to be worn with an opening in the front, one with the opening in the back. The robes are cute, so be sure to have your phone on selfie mode.
If you are having a breast MRI with contrast, a technician will insert an IV in your arm. If needles bother you, you probably already have a process to help you through. Whenever I get an IV, have blood drawn, or get a shot, I take a deep breath, look away, and think of my favorite ice cream flavor. A nurse used this trick on me in elementary school and it still helps decades later. My answer is the same—cookie dough ice cream (preferably Tillamook or Ben & Jerry’s).
Typically for an MRI, you lay on your back and are sent head first into the machine. Not so with the breast MRI. You will be in prone position—belly down, with your chest on a positioner that has openings for each breast. Before you get on the MRI table, you will be asked to remove the robe that opens to the back and unfasten the robe that opens to the front, exposing your chest. Once on the table, your tech will check and possibly physically reposition you so that your breast tissue is optimally aligned for the scan. You’ll likely be given ear plugs and possibly headphones with music options because the MRI machine is quite loud. You will be given a cord to hold that has a button to press if you need to stop the scan or talk to the technician through the two-way microphone in the machine. Once you are situated, you will be sent feet-first into the MRI tube.
If you are claustrophobic or anxious to be in the MRI tube, talk to the doctor who ordered the scan about options for medication. I’m not claustrophobic, so I haven’t worried about this part. But this is an area I’d suggest you try to anticipate and advocate for your needs in advance—I’ve never been offered medication for the scan by a technician, but I’ve heard it’s possible with a prescription. Of course if you take some kind of sedative, you will need someone there to help you home.
The scan itself will take somewhere around 45 minutes. Your tech may communicate with you throughout the exam, sometimes asking you to hold or release your breath for certain images. Around half way through, the exam will pause so your technician can inject the contrast dye in your IV that was placed earlier. I typically experience a cold flushing sensation and a metallic taste in my mouth. (Your technician or doctor will likely discuss more serious side effects to watch for). Then you will continue the rest of the scan with the same loud noises and occasional instructions from the technician.
After lying still for so long, I have a hard time not falling asleep in the MRI machine. I, um, don’t recommend this. My falling asleep hasn’t ever disrupted the scan, but I wake up feeling very disoriented.
When the scan is over, the table will move out of the MRI tube. For me, getting up from the table is the most difficult part. After lying in pone position for 45 minutes or so with a plastic, padded bar between my breasts, both my lower back and sternum are sore. My sternum remains sore for a couple days after the scan.
Your technician isn’t allowed to discuss results with you and you should receive a call from your doctor’s office when results are available. The technician will remove your IV and direct you back to the dressing room. I generally take my time in this step. I get a drink of water, use the bathroom, and change slower than normal. It takes me 10-15 minutes after the scan to stop feeling disoriented. After that time, I mostly feel hungry.
Though there are a variety of reasons your doctor may order a breast MRI, none of them are because it is fun. Whether because of your own health risks or a concerning family health history, you may feel anxious about the scan. That’s okay. And if you are not anxious, that’s okay, too. Give yourself space to feel however you feel. And if it helps, try to remember that the scan doesn’t change what is happening in your body, it only gives you more information. (If that doesn’t help, just ignore it). And if you’ve been putting off getting a breast cancer screening, maybe consider scheduling an appointment this month.