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MRI: Improving Breast Cancer Detection in Select Patients

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"Breast MRI is a valuable tool in the right patient population," says Andrew Zeiberg, MD, Virtua radiologist. "The data show that up to 10 percent of women with unilateral breast cancer may have unsuspected involvement in the contralateral breast." An American College of Radiology Imaging Network (ACRIN) Study recently assessed 969 women with unilateral breast cancer who had no clinical or mammographic abnormalities in the opposite breast. An MRI, confirmed with biopsy, demonstrated that 30 women in the group had cancer in the opposite breast: 12 with non-invasive disease, and 18 with invasive disease.

Diane Gillum, MD, Virtua breast surgeon, explains: "This news should be approached with some caution. The MRI is more sensitive than mammogram, but not necessarily more specific. As a result, there is a significant risk of false alarms with the MRI."

In the above study, 12 percent of the women required a biopsy because of an abnormality on the MRI and 75 percent of the biopsies were benign. Dr. Gillum recommends that primary breast cancer treatment not be delayed over these issues and that breast cancer patients weigh the risks and benefits of MRI with their surgeon.

For MRI screening in women without breast cancer, "defining the attributes of average-risk versus high-risk women may be difficult," says Dr. Zeiberg who suggests using a National Cancer Institute online risk assessment tool at www.cancer.gov/bcrisktool. He adds: "A thorough risk assessment helps create a treatment plan specific to an individual patient."

Dr. Gillum adds: "Standard breast cancer screening recommendations for women in a certain age category are no longer enough. We must examine the individual and her given situation and decide which tools - MRI, mammography, ultrasound - offer the best chance for detection. It is a newer, more personalized approach."

This Virtua Physician article was last updated: August 21, 2008