Having an MRI Breast Biopsy

Having an MR Imaging Breast Biopsy

Patient Information

Radiology Department

Autthor ID:         CMC

Leaflet ref:         Rad 034

Version:              1

Leaflet title:         Having an MR Imaging Breast Biopsy

Date Produced:   August 2024

Expiry Date:         August 2026

Introduction

Your clinician has referred you for a core biopsy, which is a wide needle that takes small pieces of tissue from the breast under local anaesthetic. To pinpoint the area correctly, a magnetic resonance (MR) imaging scan is used as a guide, as the area to be sampled is very small or cannot be felt.  This procedure is performed by a radiologist (a specialist doctor) and assisting radiographers.

What is an MR Imaging scanner? 

An MR Imaging scanner is a complex imaging machine containing a large open-ended tube. It is used to help diagnose disease and injury. 

Is it safe? 

MR Imaging scanners use a powerful magnet and therefore do not use x-rays. They are safe for most people; however, some people with certain magnetic or electronic objects in or on them cannot be scanned. These need to be assessed on an individual basis.

What does the scanner look like? 

Is it claustrophobic? 

You will be required to lie in the centre of the scanner (magnet). It is open ended and brightly lit. Many patients find the experience quite relaxing. About 1% of patients may feel claustrophobic during their scan. However, the Radiographers are skilled at putting you at ease and making you as comfortable as possible.

How long will I be in the MR department for?

The procedure can take anywhere between 60-120 minutes depending on the location of the area to be sampled. On average they normally take 40-50 minutes; however, due to the complexity of the procedure, a fixed time cannot be given, therefore please plan to be in the department for up to 2 hours. This allows us to complete any extra scans if needed. 

What preparation is needed before the biopsy?

You may need to have a blood test to check how well your blood will clot to make sure you are not likely to bleed heavily following the biopsy. You will also need to sign a consent form before the procedure to say that you understand what is involved and the risks of the procedure. 

You can eat and drink as normal.

How is it done?

You are positioned onto the MR imaging scanner table on your front, headfirst and you will stay in this position throughout the procedure. To obtain a sample, it is essential to position the breast within the equipment, to ensure the correct area is reached and the breast does not move. 

The positioning can take up to 10 minutes and involves some touching and squashing to the breast tissue. Once in position, you will be connected to the contrast injection and we will use pads / pillows to make you comfortable. You will need to lie very still throughout the scan. MR imaging scans can be noisy so you will be given headphones or earplugs to reduce the noise to an acceptable level. 

Will I need an injection? 

Yes, an MR contrast dye (Gadolinium) to highlight the blood supply to the breast tissue to pinpoint the sample. It will be given by a Radiographer into a vein in your arm.

You will also have an injection of pain relief into the breast before the sample is taken. 

As with all injections and medications, you may have a mild allergic reaction. You will be observed after the injection and depending on the reaction, some medication may be given to help you. This is extremely rare. You may be required to stay in the department for up to 30 minutes after the injection. 

Taking the biopsy

You will enter the scanner multiple times. The images obtained will help to pinpoint the area the area from which the biopsy will be taken through the MR breast equipment. Once in the correct position, your breast will be cleaned with antiseptic, and a local anaesthetic will be injected into the breast which may sting a little. This causes the skin to become numb. 

A special needle is inserted, then a vacuum assisted device removes the biopsy sample. Once complete a breast marker will be inserted to show where the sample has been removed from.

Will it hurt? 

MR imaging scans are painless. However, we are taking a sample of tissue with a needle, so a small injection of local anaesthetic is used to numb the area. Once this has worn off the area after around 2 hours it can become quite tender, and paracetamol can be taken if required. 

It is normal for there to be some swelling and bruising to the site, but this will gradually disappear, although in some cases this can take a few weeks. 

After your scan 

A tiny wound is left on the skin and some bleeding may occur. Sterile dressings will be applied to reduce the risk of any infections. Internal bruising (haematoma) in the breast is likely to occur following the procedure. To minimise internal bruising, firm pressure will be applied to the breast immediately after the procedure, for up to 30 minutes. There maybe external bruising that will appear. This will reduce over the next few days. 

You may be asked to wait for a while after the procedure to monitor how you feel and when you are happy you will then be taken for an x-ray to confirm the location of the breast marker. Once complete, you will be able to get changed, collect your belongings, and leave.

If any of the following symptoms occur following the procedure such as swelling of the breast, a hard/painful lump, or the breast is hot to touch, please contact the breast care nursing team on 0300 707 5720 during the following hours 09:00 – 16:00 Monday to Friday. If outside of these hours, please present to your nearest minor injuries walk in centre or the Emergency Department.

When will I get my Results?

You will not receive any results on the day of your appointment. The pieces of tissue are sent to the Laboratory where they are looked at under a microscope to help to make a diagnosis. It can take 2 weeks for the sample to be read. This will then be discussed in a specialist breast Multidisciplinary Team (MDT) meeting before the breast care team will contact you.

Relatives and Escorts 

You may wish to bring a relative or friend with you to take you home afterwards as you are having a very small surgical procedure, and you might be happy for some assistance. However, they will not normally be allowed in the MR imaging scan room.

Children/Vulnerable Adults

Please be aware that the department does not have the facilities to supervise children / vulnerable adults. If you need to bring a child or vulnerable adult with you, you must bring an appropriate adult to supervise them whilst you are having the examination. 

Interpreters 

If you require an interpreter, please contact the department before your appointment so that this can be arranged. (Please Note: Hospital policy states that relatives cannot act as interpreters).