Gattuso Rapid Diagnostic Centre
Location: Princess Margaret Cancer Centre
3rd floor, Breast Imaging
610 University Avenue
Toronto, ON, M5G 2M9

Phone: 416 946 2297
Website: Gattuso Rapid Diagnostic Centre

About magnetic resonance imaging

What is magnetic resonance imaging biopsy?

A biopsy involves taking small samples of tissue from the breast. It is done to test an area of breast tissue without surgery.

A core biopsy is a type of biopsy. The doctors will use a special hollow needle called a core needle.

Magnetic Resonance Imaging (MRI) is a type of medical imaging. An MRI is used to help find the area that needs a biopsy.

The MRI machine uses a very strong magnet and radio waves to create detailed pictures. It can create clear pictures of your organs and tissues.

During the MRI, the magnets align all the droplets of water in your body. This is only for a very short time. Then, the radio waves cause these water droplets to make very faint signals. These signals are collected by the machine to make a picture.

During a breast MRI, the doctor will inject a dye into a vein in your arm. You may hear your doctor call this dye, contrast.

The tissue samples are then sent to a pathology lab to test for cancer.

Why do I need an MRI biopsy?

You may need this test if your breast change was only seen on your routine breast MRI.

Ask your doctor these questions:

• Why do I need a biopsy?
• Who will give me my results?
• Do I need to book an appointment?
• What will the biopsy results show? What are the next steps?

Before your biopsy

How can I prepare for MRI?

Do this as early as possible:

• Ask a family member or friend to take you home. You can also bring someone for support during your appointment.

Do this the night before the appointment:

• Take a shower. The biopsy site will need to be dry for 24 hours after your biopsy. You will not be able to take a shower for a day.

Do this on the morning of the appointment:

• Take your regular medicines.
• Do not use deodorant or scented products around your underarm and breast area. They may affect how clear the images will be.
• Eat and drink normally.
• Wear comfortable clothes. Wear a 2-piece outfit that will be easy to take off and put on.

What should I bring to the appointment?

• Your health card (OHIP card).
• A supportive bra. You can wear this after the biopsy.
• Someone to drive you home (if you took relaxing medicine). It is not safe for you to drive after you take this medicine.

During the biopsy

Who will do my biopsy?

A breast radiologist and technologist will do the biopsy. A breast radiologist is a doctor who is specializes in breast imaging.

What happens during a breast MRI?

1. Before you go into the MRI room, take off any:
   • jewelry (this includes piercings)
   • hearing aids
   • wigs
   • head pieces
   • glasses
2. You go into the MRI room.
3. You lie face down on the MRI table. Your breasts are placed in a hole in the equipment.
4. A special grid paddle is used to press your breast tightly. The radiologist works through the holes in the paddle.
5. You are connected to an intravenous (IV). The IV goes into a vein in your arm and is attached to a pump. The dye travels through the pump into your vein at the right time.
6. The technologist then takes some MRI pictures. This is to make sure your breast is in the right position.
7. You are given a dye (contrast) injection through the IV. You may feel a little coolness while the contrast is being injected. This is normal. The dye helps the radiologist see the inside of the breast more clear.
8. The radiologist makes sure they can see where they need to biopsy.

   Sometimes, the breast change that was seen in your old MRI may not be seen today. If that happens, the radiologist will cancel the biopsy. The radiologist will then explain the next steps to you.

9. Your skin is cleaned.
   
10. You get a needle with medicine to numb your skin. This may sting briefly. After this you should have very little or no pain and discomfort. If you feel pain at any time during the biopsy, let the radiologist know. They may give you more numbing medicine.
11. A small cut is made on your skin.
12. The radiologist puts a needle in your breast. It is placed at the spot where you need a biopsy.
13. They take more MRI pictures. This confirms that the needle is in the correct spot.
14. The radiologist then takes some tissue samples. All the samples are taken through this one cut. You may feel some pressure when the biopsy needle is inserted. But, you should not feel pain. If you do feel pain let the radiologist know.
15. A small clip is placed into the biopsy site. This clip shows up on all your future mammograms, ultrasounds and MRI’s. It will make the area easier to find in the future. The clip is made of titanium or stainless steel. It will not activate at airport security checks.
16. After the biopsy is done, your breast is bandaged tightly. A cold ice pack is also applied to your breast.
17. The tissue samples is be sent to the Pathology Lab. A pathologist looks at the samples. A pathologist is a doctor who specializes in diagnosing disease in tissue.

How long does the biopsy take?

The appointment takes about 45 to 60 min.

But, it only take a few minutes to do the biopsy.

You will spend about 1 hour and 30 minutes in the MRI area.

After this appointment, you will go to the Breast Imaging Department for your mammogram.

After your biopsy

What should I do to take care of myself after the MRI?

The technologist will teach you how to care for yourself after the biopsy. You may have some bruising or tenderness in your breast for a few days.

Do this to care for your biopsy site:

• Wear a bra for support.
• Keep the area dry for 24 hours.
• Do not do anything to strain yourself for 1 to 2 days after your biopsy. Thing includes sports or lifting heavy things.

Do this if you have pain and swelling:

• If you need to take something for discomfort, take acetaminophen (Tylenol). Do not take ASA or acetylsalicylic acid (Aspirin) or ibuprofen (Advil) as they may cause more bruising.
• To help reduce swelling, apply an ice pack wrapped with a clean cloth to the biopsy site. Do this for 20 minutes. Repeat every hour as needed until bedtime.

Do this to care for your dressing:

• If your skin is irritated, you can remove the top dressing a few hours after the biopsy.
• Do not remove the steri-strips below the top dressing.
• The Steri-Strips will peel off on their own. This usually happens after 5 to7 days. If the Steri-Strips do not fall off after 7 days, you can remove them.

Call your family doctor if you notice any of these signs:

• fever higher than 38 ˚C (100 ˚F)
• a lot of bleeding
• redness
• swelling that is getting bigger
• pus

If you cannot reach your family doctor, go to nearest hospital Emergency Department.

If you are treated for any of the above symptoms, please call the Breast Imaging Department to let them know.

When will my results be ready?

Your nurse practitioner will let you know after the testing appointment. They will give you an appointment card with the time and place for your 2nd appointment to talk about the test results. This appointment may be on the day of testing or it may be a few days later.

What will my results show?

The results will show if the breast changes you have are benign (not cancer) or cancer. This will help you and your health care team plan what care you may need.

How can I deal with stress during this time?

Getting tested for breast changes can be stressful. It is normal to have feelings of anxiety and distress.

These feelings can change over time. It may not be the same while you are waiting to receive testing. It may change during testing. It may also change while you are waiting for your results. Each person’s experience is different. There is no right or wrong way to feel about this. This experience may mean different things to different people.

Think about what has helped you get through stressful and uncertain times in the past.

Try these tips to see if they offer you some relief:

• Talk to a supportive partner, family member or friend.
• Do an activity to help keep your mind busy. Try something you enjoy. Focusing on something other than the tests and results may help. This can include reading, listening to music, going to a movie, seeking spiritual guidance or going for a walk.
• Read trusted health information. This may help if you prefer to be informed before testing and while you wait for your results. The Princess Margaret Patient and Family Library has a many resources for patients and families. Find out more about the Library below.

If you would like to speak to someone about your concerns or feelings, please let your health care team know.

Where can I get more information?

If you would like more information, go to:

Patient and Family Library
Main atrium, Princess Margaret Cancer Centre
Phone: 416 946 4501 extension 5383
Website: Cancer Health Information

The Patient and Family Library offers trusted information about:

• cancer
• cancer treatment and care
• support organizations and services
• much more

Here you will find computer stations, books, brochures, DVDs, audio books, electronic books and CDs. Trained staff and volunteers can help with your questions and help you to find the information and resources you need.