A Question for the Ladies – Breast MRI with CRT-D?

I got a CRT-D installed in April 2019 for cardiomyopathy, and both the leads and device are MRI-compatible.  I am also high risk for breast cancer so have been getting alternating breast MRIs and mammograms every 6 months for the last 10 years or so.

I am due for my annual breast MRI in March but I’m not sure if I should try to do it or not.  I’m a little nervous about the whole thing, with having to get a device tech to put the CRT-D in and out of safe mode for the MRI, and am wondering if the MRI images will be clear enough since the device is right over my left breast.   My breast doctor seemed reluctant to order it and just said he wasn’t sure what was involved and if the quality of the images would be useful.  So now I’m not sure what to do.   The alternative would be to get a screening breast ultrasound, but I’m not sure if that is as accurate as a breast MRI for someone with moderately dense breasts like me.   Or I could just skip both and do a yearly mammogram.  

Does anyone have any experience with getting a breast MRI with a pacemaker or ICD?   How about a screening breast ultrasound?  Any advice or comments would be appreciated.




Breast screening

by Gemita - 2020-01-30 16:14:12

I feel ultrasound (good for dense breasts) and mammogram are equally good choices. I believe mammogram is still gold standard for breast cancer screening.  If further investigation is required after either ultrasound/mammogram, then proceed to MRI is what I would do. I would be unhappy to proceed with an MRI based on your doctor's comments so far.  (Alternatively find another doctor/centre who is familiar with MRI imaging of pacemaker patients?)

Only go to a hospital/centre familiar with carrying out MRI imaging on device patients.  The biggest problem we found was finding someone who knew what was required.  There is still so much fear out there about the safety of having an MRI.  It is important that both pacemaker and leads are MRI safe, the centre carrying out the imaging has experience in doing this, that cardiac technicians are available on the day to assist before and after procedure with placing device in safe mode/then restoring to normal settings and making sure that leads are unaffected.  In the latter regard, hubby during recent MRI also had a chest x-ray before and after to confirm lead position of his single lead pacemaker. The procedure went well and was straightforward with no problems afterwards.

But after reading all this you might think the ultrasound/mammogram is the way to go.   Good luck and hope all goes well


MRI and PMs.

by AgentX86 - 2020-01-30 16:17:31

I know little of breast cancer but if you have to go as far as an MRI for an exam (as opposed to the normal mammogram) I'd go for the MRI,  without a moment's hesitation. Doctors, particularly radiologists, are paranoid of pacemakers and will make you jump through hoops to get one. When you go in for the MRI, all of the MRI techs will know exactly what to do and there will be a PM tech standing by. They've seen it all before. Of course you're not going to be able to go to a doc-in-a-box and will have to go to a real hospital, with all that this entails.

If an MRI is needed because the normal screening isn't good enough in your case, it would be more that foolish to go with a lesser diagnostic, IMO.

breast MRI

by new to pace.... - 2020-02-01 15:21:05

there is another option screening Thermography  which is  a digital infrared camera looking at your breast.  You sit behind a screen and the camera looks at your breast.  Records temperatures if there is something there it shows up in color.    i had the whole body looked at as did not want anymore surprises(pacemaker).

If you do a MRI  as mentioned by others you do need to go to the main office in your hospital, rather than a branch.  make sure your Dr. puts the diaonostic code on the form.  That you give have  them make a copy of your implant card with info.  Does take a while for them to contact everyone involved.  Risk management had to approve, than it went to the dr mentioned on the implant card.  For approval.  I was told  by my the doctors office that is not needed anymore with the new devices that are MRI approved.  I then told her to call the radiology scheduling an advise them.  Then before they schedule my appt have to contain the Medtronic office in Tampa. Hopefully will hear back next week.


PM Card

by AgentX86 - 2020-02-01 15:38:18

Even though the card has the model and serial numbers of the pacemaker and the leads, I found the card to be bsolutely useless.  Neither hospital that I went to cared a hoot that I had the card.  The first just refused and said "they couldn't contact my hospital" (yeah, right).  The other wanted a signed release from my cardiologist (he didn't have anything to do with the PM) and a bunch other information.  Both yawned when I showed them the card.

Thanks for the responses

by BarbD - 2020-02-01 23:19:29

The hospital I go to does not offer thermography, so I don't think that's an option.  I'm a bit nervous that an MRI will damage the CRT in some way, or the leads will move or something.  Things seems to be going ok with the device so I don't want to do anything to rock the boat,  but I'm also nervous about not getting screened.

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