If you are at high risk for breast cancer, one of your options for taking control of your risk is getting regular cancer screening. Screening uses medical imaging techniques to check the tissue inside of your breast. Screening does not decrease the risk of getting cancer but can help detect it, often at an early stage. If cancer is detected at an early stage, there is a better chance of treating it successfully. Access to screening and the age at which you should start can vary depending where you live.


Screening Techniques

For women with a BRCA gene mutation, the recommended strategy for breast cancer screening includes both magnetic resonance imaging (MRI) and mammography.

Mammogram

A mammogram is an x-ray of your breast. It is the standard method used for breast cancer screening. A mammogram can detect breast cancer before any symptoms appear. During a mammogram, your breast is slowly compressed by a specialized machine to get the clearest image. It can be uncomfortable but should not be painful.

When should I have a mammogram?

If you are at high risk for breast cancer you would usually have a mammogram once a year. Depending on where you live, you could begin annual mammograms as early as 30 years old or 5 to 10 years earlier than the youngest diagnosis of breast cancer in your family. Guidelines vary across Canada regarding the age at which to begin and stop high-risk screening – your doctor can tell you what is recommended for you and provide you with a referral.

Learn more about mammograms


Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is usually recommended in addition to mammography for screening women at high-risk for breast cancer. An MRI uses a magnetic field and radio waves to create detailed images of your breast tissue. A breast MRI is performed by a radiologist or by a radiology technologist.

How good is an MRI at finding cancer?

MRI is more sensitive than mammography in detecting breast cancer in women with a BRCA mutation. It is better at detecting cancer in dense breast tissue (breast tissue is usually more dense in pre-menopausal women). However, MRI is not as good as mammography at distinguishing between cancerous and non-cancerous abnormalities. It is also not good at detecting tiny calcium deposits in the breast (calcifications) that may indicate cancer. For these reasons both MRI and mammography are recommended for women at high risk in order to provide the best view of their breast tissue.

When should I have an MRI?

If you are at high risk for breast cancer you would usually have an MRI once every year. Depending on where you live, you could begin annual MRI screening at the age of 30, or 5 to 10 years earlier than the youngest diagnosis of breast cancer in your family. Guidelines vary across Canada regarding the age at which to begin high-risk screening and the age to stop – your doctor can tell you what is recommended for you and provide you with a referral. Depending on where you live in Canada, MRI may not currently be offered for breast cancer screening.

MRI-patient-positioning

 

What happens when I go for a MRI?

  1. When you arrive for your breast MRI, you will need to take off any jewellery, glasses, hair pins or other metal accessories you are wearing. You may need to change into a hospital gown if your clothing has metal buttons or clasps.
  2. An intravenous (IV) line will be inserted into your hand or arm At first the IV will only contain a saline (salt water) solution. You may experience a cool feeling when the saline begins to flow. A contrast material will later be added to the IV. 
  3. You will lie face-down on a padded table that has holes for each of your breasts. See the illustration above.
  4. The table on which you are lying will then slide into the tube-shaped MRI machine. You will need to lie still for most of the scan, which lasts between 30 to 60 minutes.

How do I get ready for a MRI?

Before you go for your MRI, your doctor will ask you if you have any metal implants or metal fragments in your body. The MRI machine creates a strong magnetic pull and can cause serious problems for some metal implants. Sometimes, people with implants like pacemakers, aneurysm clips, or an intrauterine device (IUD), cannot have an MRI.

When you are getting dressed to go for your breast MRI you should not wear jewellery, hair pins or other metal objects.  You may be able to wear your own clothing in the MRI machine if it has no metal buttons or clasps.

When you have an MRI you are in a narrow, enclosed space. If you are claustrophobic (afraid of small or enclosed spaces), tell your doctor before going for a MRI scan. Your doctor may prescribe a sedative (medication) to help you relax.

What does it feel like to get a MRI?

The MRI machine creates a magnetic field around you, and radio waves are directed at your body. You won’t feel the magnetic field or the radio waves. However, the MRI machine will make very loud tapping and knocking sounds when it is scanning.

Is an MRI safe?

There is no harm caused by the magnetic field of an MRI scan. Some women may have an allergic reaction to the contrast material that is used. This contrast material may also cause complications if you have kidney or liver issues, or if you are pregnant – in these cases, the MRI may be done without it.


Breast Screening & Anxiety

Although breast screening should not have a major impact on your daily life, planning and going for regular screening may cause you anxiety and stress.

Melissa, Tori, and Farah talk about breast cancer screening

Read the transcript

What I think about most is the screening. I think that really there is the constant little voice in the back of my head saying you could very well get cancer one day.

Tori
It is normal to feel worried or afraid before your breast cancer screening appointment. After finding out that she carried a BRCA gene mutation, Tori often thought about screening. Like Tori, many women worry that their next screening exam will be the one that finds cancer. This fear usually goes away after getting normal test results.

If you are finding it difficult to deal with the cycle of fear and stress that screening may cause, you may find it helpful to learn more about coping.