Name of the Procedure:

Magnetic Resonance Imaging (MRI) with Contrast, Breast; Bilateral

Common Names:

• Breast MRI
• Bilateral Breast MRI with Contrast

Technical/Medical Term:

• HCPCS Code: C8906

Summary

A bilateral breast MRI with contrast is an imaging test that uses magnetic fields and a contrast dye to create detailed pictures of both breasts. This procedure helps healthcare providers assess breast tissue more clearly than standard imaging techniques.

Purpose

• Medical Conditions:

  • Breast cancer
  • Suspicious breast lumps
  • Unexplained breast symptoms
  • High-risk breast screening

• Goals/Outcomes:

  • Detect abnormalities or tumors
  • Determine the extent of breast cancer
  • Guide biopsy procedures
  • Monitor response to breast cancer treatment

Indications

• Unresolved issues after a mammogram or ultrasound
• High genetic risk for breast cancer
• Diagnosed breast cancer to evaluate the opposite breast
• Post-surgical assessment (e.g., implants, reconstructive surgery follow-up)

Preparation

• Pre-procedure Instructions:

  • Fasting for 4-6 hours prior if sedation is used
  • Removal of metal objects and jewelry
  • Informing the technician of any implants or allergies to contrast dye

• Pre-assessments:

  • Kidney function tests (to ensure safety of contrast dye)
  • Allergy history and current medications review

Procedure Description

1. The patient lies face down on a specialized platform with openings for the breasts.
2. An intravenous (IV) line is started for the contrast dye.
3. The table slides into the MRI scanner.
4. Images are taken before and after the contrast dye is administered.
5. The dye enhances the visibility of tissues and any abnormalities.
6. The procedure usually involves multiple sequences of imaging to capture detailed pictures.

Tools and Equipment:

• MRI machine
• IV contrast dye
• IV administration set

Anesthesia:

• Not required, but sedation may be used for claustrophobic patients.

Duration

• Typically takes 30 to 60 minutes.

Setting

• Performed in a hospital, outpatient imaging center, or specialized diagnostic facility.

Personnel

• Radiologist
• Radiologic technologist
• Nurse (for IV insertion and patient monitoring)
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common Risks:

  • Allergic reaction to contrast dye
  • Claustrophobia or discomfort

• Rare Risks:

  • Kidney problems from contrast dye
  • Injection site issues (e.g., infection or bruising)

• Management:

  • Immediate treatment for any allergic reactions
  • Hydration for kidney function support

Benefits

• Highly detailed images of breast tissue
• Early detection of abnormalities
• Improved accuracy in diagnosing and treating breast conditions
• Benefits may be realized shortly after image analysis (typically within a few days)

Recovery

• Post-Procedure Care:

  • Hydrate well to help flush contrast dye from the body
  • Monitor the IV site for any signs of infection

• Recovery Time:

  • Immediate return to normal activities if no sedation is used
  • Short observation period if sedated, with restrictions on activities for 24 hours

Alternatives

• Other Options:

  • Mammography
  • Breast Ultrasound
  • 3D Tomosynthesis

• Pros and Cons:

  • Mammography:
    • Less expensive, less detail, uses X-rays.
  • Ultrasound:
    • Good for solid or cystic masses; less detailed than MRI, no radiation.
  • 3D Tomosynthesis:
    • Enhanced mammography with better detail; still less comprehensive than MRI.

Patient Experience

• During Procedure:

  • May feel brief discomfort from IV insertion
  • Slight pressure when lying on the platform
  • Noise from the MRI machine, earplugs or headphones offered

• After Procedure:

  • Temporary side effects from contrast dye like nausea or headache
  • Mild tenderness at IV site

Pain Management and Comfort:

• Clear communication and reassurance
• Sedation options for anxiety or claustrophobia
• Comfortable padding and positioning during the scan