With a clinical exam, there is the assumption of standard clinical practices, which are still evolving in the field of breast MRI. Also, you are responsible for paying for the exam. Insurance companies may not pay for a breast MRI exam, since it's still considered experimental; be sure to check with them first. Evolving technology, the most up-to-date protocols and the high expense may make it wise to enroll in a research study--the exam is usually free to you and your insurance and there might be more complete follow-up.
With a unilateral versus a bilateral exam, there is a tradeoff in information. There is much better resolution (better, bigger pictures) by only looking at one breast--most exams are done this way. However, many patients are concerned about both breasts.
Body parts need to be imaged by a specific coil to get the best pictures possible. For example, a head MRI requires the head to be surrounded by a head coil. You can image the breast using a general body coil, however, the images will be much better when a dedicated breast coil is used. Therefore, it is in your best interest to only do a breast MRI exam if a dedicated breast coil is used.
Find out about the radiologist's background, how long s/he has been reading breast MRI images, what type of research s/he's been involved in and where.
At this point, Breast MRI should NOT take the place of regular diagnostic procedures (clinical exam, mammogram, biopsy) in making treatment or surgical decisions. It should only be used as additional information.
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