Name of the Procedure:

Magnetic Resonance Imaging (MRI) with Contrast, Breast; Unilateral (HCPCS Code: C8903)

Summary

Magnetic Resonance Imaging (MRI) of the breast with contrast is an advanced imaging technique that produces detailed images of breast tissue. This procedure uses a magnetic field, radio waves, and a contrast dye to enhance image clarity, helping doctors detect abnormalities in one breast.

Purpose

MRI with contrast for the breast is particularly effective at identifying:

• Breast cancer, especially in dense breast tissue
• Tumors that may not be visible on a mammogram or ultrasound
• The extent of cancer spread or response to treatment

The goal is to provide highly detailed images that can lead to accurate diagnosis and guide treatment plans.

Indications

• Unusual findings from a mammogram or ultrasound
• High risk of breast cancer due to genetic factors (e.g., BRCA1 or BRCA2 mutations)
• Monitoring for recurrence after breast cancer treatment
• Evaluating the integrity of breast implants

Preparation

• Fasting may be required for a few hours before the procedure.
• Patients should inform their doctor of any allergies, particularly to contrast dye.
• Remove metal objects, as they can interfere with the MRI machine.
• Diagnostic tests such as prior mammograms or ultrasounds may be reviewed.

Procedure Description

1. The patient lies face-down on a padded scanning table, with the breast positioned through an opening.
2. An intravenous (IV) line is placed to administer the contrast dye.
3. The patient is moved into the MRI machine, which creates a strong magnetic field.
4. During the scan, the patient must remain still while the machine takes images.
5. The contrast dye is injected mid-scan to enhance the visibility of tissues.

• Tools/Equipment: MRI machine, IV line, contrast dye
• Sedation: Generally, no sedation is required, but sedatives may be offered for claustrophobic patients.

Duration

The entire procedure typically takes 30-60 minutes.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• MRI Technologist
• Nurses (if IV contrast is used)

Risks and Complications

• Mild allergic reaction to the contrast dye
• Discomfort from lying still
• Rare complications include kidney problems from the dye, especially in patients with pre-existing kidney conditions

Benefits

• High accuracy in detecting breast abnormalities
• Non-invasive with no radiation exposure
• Detailed images that aid in treatment planning

Recovery

• Short observation period post-procedure to monitor for adverse reactions to the dye
• Resume normal activities immediately unless otherwise advised
• Follow-up appointments as necessary based on results

Alternatives

• Mammography: Less detailed, uses low-dose X-rays
• Ultrasound: Helpful for certain conditions, often used in combination with other tests
• Breast biopsy: Provides a tissue sample but is more invasive

Each alternative has its own advantages and may be recommended based on the specific clinical scenario.

Patient Experience

• The patient might feel a cool sensation from the contrast dye injection.
• The MRI machine can be noisy; earplugs or headphones are usually provided.
• Some patients may feel claustrophobic; talking to the technologist through a communication system can help.
• Mild discomfort from lying still for an extended period.