MRI-guided Breast Biopsy

MRI Breast Biopsy

Breast magnetic resonance imaging (MRI) is the most sensitive imaging modality for the detection of breast cancer. In recent years, it has become the modality of choice for screening high risk populations, local staging and monitoring of the disease.

With the increasing use of breast MRI, radiologists are able to detect more lesions in the breast which are not seen on mammography or ultrasound. It is important that these lesions are assessed with a biopsy to guide appropriate management. In cases where an abnormality is seen on MRI only, an MRI-guided breast biopsy will need to be performed to obtain a diagnosis.

This biopsy is performed for ‘MRI-only’ lesions, in other words, lesions that have been picked up on a breast MRI scan that are not seen on mammography or ultrasound.

The presence of the following conditions or devices could mean it may not be safe to perform a breast MRI or MRI-guided breast biopsy:

  • Presence of metallic devices e.g. pacemaker, aneurysm clip, tissue expander
  • Allergy to gadolinium (contrast agent)
  • Pregnancy
  • Renal failure
  • Any problems with blood clotting or anticoagulation therapy e.g. warfarin

If you are booked for an MRI-guided breast biopsy, it is essential to inform the staff before your appointment date of any of the above conditions or devices.

An MRI-guided breast biopsy is an outpatient procedure which takes approximately 30-60 minutes to perform. The procedure is carried out in the radiology department by a breast radiologist with the necessary expertise in performing MRI biopsies.

During the biopsy, patients are positioned prone (lying on their tummy), and the affected breast is compressed. Contrast is injected intravenously to identify the correct area for biopsy.

Once the area for biopsy has been identified, local anaesthetic is administered into the breast to ensure the patient is completely pain-free during the procedure.

 A needle is then placed into the breast to remove small fragments of tissue for laboratory assessment.

 A marker clip is placed in the breast which is essential to aid future localisation.

If you have been booked for a biopsy, you will be asked to change into a hospital gown when you arrive in the department. Your personal belongings will be placed in a locker for safekeeping.

You will be introduced to the team that will be looking after you, as well as the radiologist who will be performing the biopsy. The radiologist will explain the procedure to you before starting so you know exactly what to expect.

Once all safety checks have been done and consent for the procedure has been obtained, an IV line will be inserted in your arm. You will then be taken into the MRI scanning room and positioned for the procedure to commence.

Once the biopsy is complete, pressure will be applied to the biopsied breast for ten minutes and then dressings will be applied.

The radiologist will discuss with you how to care for the dressings, when these should be removed, and which analgesia is safe to take at home if this is required.

You will be given an appointment for a post-biopsy mammogram to assess the marker that has been placed in the breast, and will also be advised when to follow up with your doctor to get your results.

Your biopsy specimen will be sent off immediately to the pathology laboratory of your choice.

MRI-guided breast biopsies are performed at our Westville Hospital branch.

You will need to provide us with a referral letter from your doctor and your medical aid details so that authorisation can be obtained prior to your biopsy date.

Westville Hospital
7 Harry Gwala Road, Westville, 3630
Tel: 031 521 0372

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