Full-Protocol Breast MRI

For women with average risk of developing breast cancer, full-protocol MRI is used as a supplemental diagnostic tool to evaluate suspicious areas in the breast found on a mammogram. 

It’s recommended that women with high risk of developing breast cancer undergo screening mammograms with full-protocol breast MRI to monitor their health. Your physician can best determine whether you are an appropriate candidate for regular breast MRI. 

What are the American Cancer Society guidelines for full-protocol breast MRI?

The American Cancer Society recommends an annual breast MRI for women who meet at least one of the following conditions:

  • BRCA1 or BRCA2 gene mutation, or first-degree relative with either gene mutation
  • Lifetime risk of breast cancer scored at 20 to 25% or greater (generally corresponds to two first-degree relatives with breast cancer)
  • Radiation to the chest between the ages of 10 and 30
  • Li-Fraumeni/Cowden/Bannayan-Riley-Ruvalcaba syndromes, or patient may have one syndrome based on history in first-degree relative

Full-protocol breast MRI may be beneficial but is not routinely recommended for women who have:

  • Lifetime risk of breast cancer scored at 15 to 20%
  • Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH)
  • Atypical ductal hyperplasia (ADH)
  • Very dense or unevenly dense breasts
  • Already had breast cancer, including ductal carcinoma in situ (DCIS)


A registered technologist will oversee your exam, carefully positioning you on a padded scanning table that gently slides into the MRI magnet where the imaging is performed. To obtain the best images, you will lie face down with two cushioned openings that are surrounded by a special device called a breast coil. This device acts as a signal receiver and works with the MRI scanner to create the images.

An initial series of scans will be taken. You will then be given an intravenous injection of contrast to better visualize the breast tissue. Then, a second set of images will be taken.

Because MRI uses no X-rays and ionizing radiation, it presents no known risk to adults and children. If you are pregnant or nursing, you should consult your physician about having intravenous contrast “dye” before having an MRI exam. MRI without intravenous contrast is safe for pregnant and nursing patients.

A registered MRI technologist will help you prepare for the exam, position you on the table and perform the exam as directed by the radiologist. Together, this medical team will oversee your care and ensure you are comfortable. The exam will be interpreted by a board-certified breast specialized radiologist with specialized expertise in MRI evaluations and reporting.

A board-certified breast specialized radiologist will interpret your scan and the dictated results will be sent to your referring physician, usually within 24 to 48 hours. Your physician will then share the results with you.

There are some situations where MRI is not recommended due to the use of the high-field magnet. We will review these details with you during scheduling to be sure you are an appropriate candidate for MRI. These conditions include, but are not limited to:

  • A heart pacemaker
  • Some other implanted electronic medical devices, such as cochlear implants
  • Severe claustrophobia

The Washington Radiology nurse overseeing your care will call you several days before the exam to review preparation and any conditions that may make it unsafe to have an MRI. Most people with metal or non-electronic implants can have an MRI.

Preparing for Your Exam

Patient peace of mind starts with the right preparation. In addition to the written order from your physician, bring any prior images or reports from outside Washington Radiology with you to your appointment, if related to the reason for your visit with us.  

For all MRI patients, we request the following:

  • Continue to take any medications prescribed by your physician, unless otherwise directed.
  • Wear comfortable clothing without metal zippers, buttons, hooks, etc.
  • Because of the magnetic field, do not wear metal hair clips or eye makeup that may contain small metallic flecks, which can interfere with your scan.
  • Leave jewelry and valuables at home.
  • A secure locker will be available to leave metal objects, like your keys and watch.

Breast MRI With and/or Without Contrast

  • Inform us if you have a pacemaker, artificial heart valves or any metal objects in your body, or if you are pregnant or nursing.
  • Do not eat or drink two hours before your exam.
  • The timing of the exam should be linked to the menstrual cycle for women who are premenopausal. The best time to perform a breast MRI is between 6 and 12 days of the patient’s menstrual cycle. If a patient has irregular menstrual cycles, the exam can be scheduled any time with the understanding that residual hormonal activity can render the exam difficult to interpret. For patients who are postmenopausal, the exam can be performed any time. 

If you have follow-up questions about these MRI preparations, contact the Washington Radiology office where your exam is scheduled and ask to speak with the nurse.

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