SmartBreast MRI™ Sarah Kulynych July 29, 2025
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SmartBreast™ MRI

Women with dense breasts can benefit from supplemental screening with one of Princeton Radiology’s SmartBreast MRIs. SmartBreast MRI can detect more than twice as many breast cancers as 3-D mammography alone – and often at earlier, more treatable stages.

What are dense breasts?

Breast tissue is composed of dense fibroglandular tissue (milk glands and ducts, muscle and connective tissue) and non-dense fatty tissue. The more fibroglandular tissue you have, the denser your breasts are. Dense breast tissue is very common and not abnormal. However, dense breast tissue is associated with an increased risk of developing breast cancer because glandular tissue makes it harder to see small tumors and can make screening more difficult.

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Breast density is not based on your overall body habitus.

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Breast density is not related to your breast size or firmness.

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Breast density can only be determined by a mammogram.

At Princeton Radiology we call a mammogram a SmartMamm® because the reports include your type of breast density, along with your lifetime risk assessment of breast cancer – to help you and your doctor determine the right monitoring plan for you. Some early-stage concerns are more difficult to detect on mammograms alone. That’s why an additional study may be recommended.

Categories of Breast Density

Nearly half of all women aged 40 and older who have mammograms are found to have dense breasts (either heterogeneously or extremely dense). Women with 50 percent or higher breast density are three times more likely to be diagnosed with breast cancer than women with less than 10 percent breast density (Journal of the National Cancer Institute, Aug 2011).

mammogram image showing almost entirely fatty breast tissue, categorized as Type A densite

Type A
Almost Entirely Fatty

mammogram image showing scattered fibroglandular densities, categorized as Type B breast density

Type B
Scattered Areas of Fibroglandular Density

mammogram image showing heterogeneously dense breast tissue, categorized as type c density

Type C
Heterogeneously Dense

mammogram image showing extremely dense breast tissue, categorized as type d density

Type D
Extremely Dense

  • Individuals with an average or high risk of breast cancer or concerns due to family history or other reasons –  likely to be a candidate for our Diagnostic SmartBreast MRI™. Click here to learn more about that specific exam.
  • Individuals with no history of breast cancer, but have dense breasts and want to be proactive about their breast health -likely to be a candidate for our SmartBreast MRI™. Click here to learn more about that specific exam.
  • If your CT exam is ordered with oral or IV contrast, you may consume CLEAR liquids ONLY within 4 hours of your examination. You may have coffee/ tea WITHOUT milk, jello, broth, soda, and grape cranberry or apple juice.
  • If you are having an abdominal and/or pelvic CT, you may require oral contrast. You will need to pick up the contrast at our office at least 24 hours prior to your appointment and follow the instructions given for taking the contrast. Your Scheduler will inform you if you need oral contrast for your study.
  • Remember to bring your prescription and your insurance card to your appointment.
  • Arrive at our office 30 minutes prior to your scheduled appointment time. These 30 minutes will allow you to complete a medical history form and to finish drinking the oral contrast – if applicable – before your study begins.
  • Prescription medications may be taken as usual. IF YOU ARE DIABETIC: Do not take Metaglip, Glucophage, Glucovance, Avandamet (or any drug containing Metformin) the day of your exam and for 48 hours after your exam.

SmartBreast MRI is a non-invasive imaging exam without ionizing radiation. Patients lie in the MRI machine, while an extremely safe contrast agent is administered intravenously into the arm. The MRI machine then uses magnets and radio waves to produce detailed 3-dimensional images of the breast tissue.

On the SmartBreast MRI, the contrast agent becomes more concentrated in areas of cancer growth, showing up as white areas against a dark background. This helps radiologists determine which areas may be of concern.

A small percentage of breast MRIs require additional testing. These might include a follow-up diagnostic SmartBreast MRI™, breast ultrasound, diagnostic SmartMamm® (mammogram), or biopsy.

Yes! Even with dense breasts, mammograms are the only imaging exam proven to reduce breast cancer mortality. Mammograms also help detect changes in the pattern of your breast density, which is critical for detecting breast cancer early. We recommend that you continue with annual mammograms.

This exam is available at the following locations:

Types of SmartBreast MRI Exams

Princeton Radiology offers both Diagnostic SmartBreast MRI and Screening SmartBreast MRI™. Most insurance plans cover Diagnostic SmartBreast MRI™ for women at increased risk of developing breast cancer, such as those with a Claus risk score of 20+ on their SmartMamm™ report, and/or an inherited conditions such as BRCA 1 or BRCA 2 genetic mutations. Get your Claus score here

If a Diagnostic SmartBreast MRI™ exam is not covered by your insurance, our Screening SmartBreast MRI™ is available for the low, self-pay fee of $375.

Diagnostic SmartBreast MRI™ 

  • Exam time: approx. 30 minutes
  • Recommended as a follow up to a SmartMamm® if you have an average risk of breast cancer, but have concerns due to family history or other reasons
  • A physician’s order is required

Additional reasons to consider a Diagnostic Smart Breast MRI™ include:

  • General concerns about breast health and risk factors not resolved with a mammogram
  • Discovery of a lump/mass during a physical exam, ultrasound or mammogram
  • Concerns about the integrity of breast implants
  • Distinguishing between scar tissue and recurrent tumors
  • Staging of breast cancer to make the best treatment decisions

Screening SmartBreast MRI™

  • Exam time: approx. 10 minutes
  • Recommended for concerned patients and their doctors when referral for diagnostic breast MRI does not meet insurance coverage requirements
  • Not covered by most insurance plans; out-of-pocket cost: $375
  • A physician’s order is required

Additional reasons to consider a SmartBreast MRI™ include:

  • Dense breasts and/or an average risk of breast cancer
  • Additional safety net that detects 15 to 18 more breast cancers per 1,000 screenings
  • Ability to reveal aggressive cancers, as it detects tumors that are vascular and can grow quickly in between annual mammograms

Over 60 years of excellence in imaging.

And that’s just one reason why Princeton Radiology is the right choice.

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Expertise you can rely upon.

Interpretations by board certified, sub-specialty trained radiologists.

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We respect your time.

Fast scheduling, less time in the waiting room, and same-day or next-day results in most cases.

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Patient-friendly hours.

We cater to patient schedules with daytime, evening and weekend hours for many exams.

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Comfortable experience.

From our friendly and caring staff to our beautiful imaging facilities, everything we do is patient-focused.

Gold and blue ACR American College of Radiology MRI Accredited Facility seal, indicating certified quality and safety in magnetic resonance imaging services.
Gold and blue ACR American College of Radiology Breast MRI Accredited Facility seal, recognizing excellence and quality in breast magnetic resonance imaging.
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