Ask Dr. Ulissey | November Q/A

Q. I recently saw a celebrity news story indicating a breast MRI is not safe. Can you tell me these details?

A. I believe the article to which you are referring is where a celebrity is suing a medical device manufacturer because he claims that the contrast agent in a breast MRI somehow left his wife weak, tired and with various intermittent bouts of discomfort.

In my opinion, a breast MRI is safe. It is also an invaluable tool that greatly benefits women when it’s used properly.

The contrast agent in question is called gadolinium. Literally hundreds of millions of women have undergone a breast MRI over the last several decades, and if there was something significantly harmful, we would have known by now. The FDA has reviewed data on gadolinium, and so have multiple European drug agencies, and all have found it to be generally safe (barring, of course, known medical problems you may have, such as kidney failure).

Having written the above, I will add that no drug is perfect, and most have some kind of side effect. What’s more, in another 20 years we may learn more about longer term effects, so to that end, various offshoots of gadolinium have been developed to limit these possible outcomes. One agent that is popular in Europe because it seems to have fewer side effects is gadoterate meglumine, and it is also becoming more used in the United States.

Many researchers also think that doing a breast MRI every other year on some high-risk women might be just as effective as yearly, and that would reduce the lifetime-accumulated dose by half. There is no medical evidence yet that indicates this has to happen, but my feeling has always been that it is best to administer the minimum amount of drug needed to gain the maximum information from the test (in this case, a breast MRI).

Reach Michael J. Ulissey, M.D., a partner at the Breast Diagnostic Centers of Auburn and Federal Way, at mike@breastdiagnostic.com.