In order to fully evaluate the extent of disease and to check the lymph nodes in the axilla (armpit) and the other breast, we will ask for a bilateral breast MRI. We use MRI because we want to know as much information about you in order to offer the best surgery up front.
MRI is different from a mammogram (X-ray) and ultrasound. It evaluates the blood flow characteristics that may be associated with abnormal breast tissue (such as cancer) and is very sensitive. However, although the technique is very sensitive, and good at picking up abnormalities, it is not always very specific, or good at distinguishing the various abnormalities (i.e. benign findings such as cysts or changes due to hormonal fluctuation vs. cancer). Therefore, if there are additional abnormal findings on MRI, mammogram and ultrasound targeted to the additional areas are used to help figure out if any additional biopsies need to be performed. Sometimes, if nothing is found on mammogram or ultrasound, we will likely order another MRI in six months to recheck the area, similar to getting a six-month follow-up mammogram.