Do I need the contrast dye?
I have fibrocycstic breast tissue. The radiologist who performed my core needles biopsies in June recommended I get breast MRI's done. I go next Wednesday but I see the prep says I will be injected with contrast dye. I am very concerned about this as I have bad allergic reactions. I am wondering if anyone knows how important it is to get the contrast dye or not. Also has anyone done it without? If so do you know if the images were clear enough? Thanks
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I haven't had an MRI for breast issues yet but I've had several for neurological abnormalities, and there has been a huge difference in what shows before they inject gadolinium contrast vs after. I'm really medication sensitive and out of my 5+ brain MRIs w/contrast I've only felt a little queasy after the last one. The risk with contrast is really low, even for people with allergies. I know it's a bit scary to have something new introduced to your body, but with serious issues the benefits outweigh any teeny tiny risk. Wishing you all the best!
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Hi mvr168, So MRI is done with the injection of gadolinium and most people are fine with it. You may feel a little warm when it is injected and that's about it. In case you are wondering it is not the same as CT contrast. With breast MRI contrast is preferred . Images are acquired before and after contrast and this helps the radiologist with diagnosis especially if there is an abnormality on the pre-contrast images.
If you are concerned about a possible reaction you can discuss with your doctor the option of taking a steroid prep prior to your study. That will help reduce the possibility of an allergic reaction.
Good luck and sending good vibes for a negative study.
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I would suggest discussing your concerns about an allergic reaction with the doctor prior to your appointment to avoid any misunderstandings or being rushed. You don’t mention the results of your biopsies however, I would also recommend discussing with your doctor if an MRI is really needed. While it may necessary, many doctors are under pressure to recommend an MRI as a way to increase revenue so it may not be appropriate in every case.
Please keep in mind that private equity and investment groups provide funding behind many medical groups and hospitals in the U.S. and their focus is on revenue, not best patient care. This is why you may see a PA or NP rather than an MD because it reduces labor costs. I have had this experience with my MO who is part of a large medical group at an NCI cancer center. When I asked for her rationale in recommending a MRI she admitted there was none in my case but is under pressure to recommend an MRI. After I questioned her, she has not brought it up again. A little research on my part indicated the medical group she belongs to is funded by a private investment firm that plans to turn over the business in a few years to reap a profit.
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Bringing back the topic of an allergic reaction to the MRI contrast dye and whether there is a way to proceed either with the contrast dye or without. I had a mild reaction to my first contrast MRI last fall: swollen lip and hives on my back, but no respiratory distress. The brand name was Prohance. At the time, although it was suggested that Prohance not be used again, no one suggested that I'd never be able to have another MRI due to the allergic reaction. However, at my latest MO appointment, the PA said just that. No more MRIs period because all contrast dyes contain the same ingredient that caused the reaction.
My question is whether there is any other position on this. Is it true that there is no way to have another contrast MRI? Cookie54 suggests that perhaps a steroid or other pre-medication to avoid the reaction while still allowing for the benefits of the MRI, so I'm thinking I should ask the MO doc to weigh in on this. I was triple negative and take no other medications so I rely on imaging quite a bit. Having the MRI off the table is of great concern if there are no other options that are as good.
Any thoughts? Thanks so much!
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Hey ladies , hope your doing ok .
Not sure if I mentioned before but I worked in Radiology for many years . With that said here was our standard protocol regarding contrast reactions for outpatient. A mild reaction like itching or hives patients were to be steroid prepped for next exam. Next exam if were premedicated and still had hives then following exam had to be done premeds in a hospital setting. Any respiratory distress (tongue or throat ,facial swelling ,short of breath)the next exam with contrast has to be in the hospital setting with premeds.
Sometimes studies are just done without contrast. Basically the referring physician has to decide whether the risk is worth the measure. The facility performing has the last say as to whether they feel comfortable with the level of patient risk.
Each facility has their own protocol regarding steroid prep and risk they are willing to take. Outpatient centers all have to have a "Crash Cart" with all the necessary meds to combat a reaction. Radiologists are trained how to handle an emergency and most are fine with mild reactions. At least if you have a severe reaction you have a code team in the hospital.
Also there are patients that have had a reaction with one brand of gadolinium and not another. So I would be hesitant to say they are all the same. Gadolinium is either linear or macrocyclic agent.
In general the reactions occurring with MR contrast are very low but there is always a small risk. Hope this helped to explain.
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@cookie54 Thank you so much for that information! I will definitely bring this all up with the MO and/or the facility where I've been getting my imaging. As it turns out, that department is just down the hall from the emergency department so with any reaction I'd have a very short trip. In fact, when it first happened, the hallway outside the MRI room filled up immediately with just about every nurse, EMT, doc, etc. who happened to be anywhere nearby. In true parade fashion, they all wheeled me on a stretcher the 50 feet to the ED where I spent the next three hours under observation. And again, thank you!!!!!!
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Hi cookie54, just an update. I spoke with my breast surgeon who said I was OK to go without the MRI. So, I'll go with that. I guess it's all a crapshoot anyway… Thanks for the support, though! - Anne
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Does anyone know if this means I’m to have it with or without? My order says:
w/wo contrast
I think that means to do it both ways but the girl on the phone says it means without.
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@txabby This order means scan without contrast followed by with contrast. So you are correct. Best wishes.
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I have breast MRIs once a year, started out having them every six months, because of dense breast tissue. It was the only thing that picked up the cancer. Mammograms showed nothing. The MRI is painless. Anyway, w/wo means both will be done...with contrast and without contrast. I never had a problem with the contrast. But you do need to drink lots of water afterwards to help flush it out. Good luck!
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