Médico Express specialist explains the benefits of breast MRI

Breast MRI does not replace mammography: it complements it when breast tissue is dense or the risk is high. Dr Melisa Ravelo explains when it is indicated, how the patient prepares and what it can see that other studies cannot.

Santo Domingo. – Breast magnetic resonance imaging is a complementary tool for detecting and assessing breast cancer, particularly in women with dense breast tissue or a high risk of developing the disease.

Although mammography remains the main screening study, this technique makes it possible to identify lesions that might otherwise go unnoticed and provides additional information to guide medical decisions.

Dr Melisa Ravelo, a radiologist at Médico Express, explains its main benefits, indications and limitations.

Complementary studies and high-risk patients

MRI uses a magnetic field and radiofrequency waves, so it involves no radiation. It generally requires an intravenous contrast agent. Unlike mammography, which uses X-rays and can detect microcalcifications, this test shows how tissues behave and how any possible lesions take up the contrast.

Sonography, by contrast, uses ultrasound and helps to tell cysts apart from solid lesions. Each method provides different information and serves a specific purpose in breast assessment.

This study is indicated mainly in women at high risk of breast cancer, such as those with BRCA1 and BRCA2 genetic mutations or an estimated lifetime probability of developing the disease of 20 % or higher.

It is also used to determine the extent of a newly diagnosed cancer, to assess the response to chemotherapy and to study cases in which other imaging methods give inconclusive results.

In women with dense breasts it offers an advantage, because its ability to identify lesions does not depend on tissue density. It can also detect small tumours and other cancerous foci that mammography does not show.

Assessment, preparation and recommendations

Once the diagnosis is confirmed, it makes it possible to establish the size of the tumour, locate additional lesions and determine whether nearby structures, such as the pectoral muscle or the skin, are affected. These findings help the medical team to plan treatment.

For the procedure, menstruating women are advised to attend between days 7 and 14 of their cycle. They should also bring their previous studies and tell the medical staff if they have claustrophobia, allergies or metal devices. A creatinine test is also requested to assess kidney function.

The examination lasts between 20 and 40 minutes. During the procedure the patient lies face down and receives gadolinium intravenously to improve the visualisation of any possible abnormalities.

The specialist points out that in most cases this technique does not replace mammography but complements it. Its high sensitivity may also identify benign changes that call for further assessment or biopsies.

For this reason, she recommends knowing the family history of breast or ovarian cancer, finding out whether breast tissue is dense and consulting a doctor about the most suitable studies in each case.

About Médico Express

Médico Express is a leading outpatient health centre in Santo Domingo Este, designed to international standards to provide comprehensive, personalised and people-centred care. Its service model brings together more than 40 medical specialities, state-of-the-art technology, advanced diagnostics, outpatient surgery, emergency care, telemedicine and prevention and wellbeing programmes, with an emphasis on humane, efficient and safe care.

Its achievements include international certification in Patient Experience, awarded with distinction by Global Healthcare Accreditation (GHA), making it the first centre in Central America and the Caribbean to receive this recognition. It also holds Fitwel certification, which endorses its facilities as spaces designed to promote the health and wellbeing of patients, staff and visitors.