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Can Breast MRI Help Assess Cancer?

The study weighs the benefits and risks of normal breasts MRI for cancer evaluation

NS
Kathleen Doheny
WebMD Health News

Reviewed by
Louise Chan, MD

September 08, 2008-Daily use of the breast MRI (((Magnetic resonance imaging) Scans useful for evaluation cancer According to new research, it’s not as beneficial as some people believe after diagnosis.

“The bottom line is that it doesn’t help as we expected,” said Dr. Richard J. Bleicher, a surgical oncologist at Fox Chase. cancer The Philadelphia Center and lead author of the study was presented at the American Clinical Society on Saturday. Oncology breast cancer Symposium in Washington DC

However, another expert who reviewed WebMD’s research outline said the study was small and the role of the breast was MRI Evaluate cancer It’s still evolving.

At some point, all sides seem to agree. Further research is needed to determine if MRI can improve female outcomes. breast cancer..

Breast MRI

Bricher and his colleagues reviewed 577 records breast cancer Patients, including 130 who had MRI before treatment and 447 who did not. The goal was to determine the time to start treatment, the likelihood of removing all cancers, and the effect (if any) of obtaining an MRI on other outcomes.

“We wanted to see if it was a routine MRI [for cancer, not for screenings] Can you help and actually help with your treatment plan, “Bleicher told WebMD.

He says the role of breast MRI for screening is clearer. For example, the American Cancer Society recommends using MRI in combination with mammograms for prophylactic screening of certain women who are at particularly high risk for breast cancer.

However, the role of breast MRI in assessing breast cancer is less clear, he says.

The idea among experts is that MRI is so sensitive that it may be possible to better visualize the cancer, so using MRI when cancer is diagnosed or suspected can guide treatment decisions. He says it should help.

Breast MRI findings

In the survey results:

  • Breast MRI was associated with a 22-day delay in starting treatment. “I don’t know why,” says Bleicher. It may be due to the schedule of the MRI itself. Alternatively, an MRI may prompt another biopsy. anxiety..
  • People who had a breast MRI were almost twice as likely to have a breast MRI. Mastectomy As a breast-conserving surgery, even after controlling size and stage tumor.. He says one of the reasons may be that the MRI was so sensitive that he picked up what looked like cancer, but found that it wasn’t a false positive.
  • Those who underwent breast MRI were slightly more likely to have what the surgeon called a positive margin, but this finding may have been a coincidence. The goal is a negative margin. “The goal is to remove the tumor so that it has a margin of normal tissue around it, reassuring us that the cancer has been completely removed,” he says.
  • Younger women were more likely to have MRI than older women, but the use of MRI was a family history of the breast and Ovarian cancer..

Evolving breast MRI research

Another expert, Doctor of Medicine Constance Lehman, Professor and Vice-Chair of Radiology, Head of Breast Imaging at the University of Washington Medical Center, Head of Imaging in Seattle Cancer treatment The Alliance has reviewed WebMD’s work. She states that the new study is “not the kind of study needed to reach a firm conclusion.”

She points out that the study was small and only 130 women had breast MRI.

Research on the value of breast MRI when used in cancer treatment decisions is evolving, she says, and not all answers are available.

Bleicher’s work has its own limitations, she says. Because it wasn’t a study of randomizing people to get one treatment. Rather, it was a retrospective study, lacking some information, such as why some women had MRIs and others did not.

The findings from current research go beyond her core, she says.

“This study should not rule out preoperative MRI. It is one summary from one center that conducted one study in a highly selected patient group,” she says.

She points out another study, Journal of Clinical OncologyWe reviewed the results of 19 studies and found that the rate of mastectomy due to false positives on MRI was 1%.

Breast MRI: Advice for women

If a woman suspects or diagnoses breast cancer, Lehman says she should ask about the potential benefits and risks of breast MRI.

“Go to an experienced center,” she advises.

Bricher’s advice: “Women who enter the clinic with breast cancer should not immediately think that they need an MRI.”There is a false positive [to MRIs], Unnecessary biopsy, lots anxiety … and 3 weeks late [to treatment].. All of these disadvantages are not offset by the increased ability to choose the right treatment. “

Further research is needed to determine the best role of breast MRI in diagnosing cancer, he says.

Source: Constance Lehman MD, PHD, Professor and Vice-Chair of Radiology, Head of Breast Imaging at the University of Washington Medical Center in Seattle, Head of Imaging for the Seattle Cancer Care Alliance. Dr. Richard J. Bricher, a surgical oncology scholar and co-director of the Breast Fellowship Program at the Fox Chase Cancer Center in Philadelphia. American Society of Clinical Oncology Breast Cancer Symposium, Washington, DC, September 5-7, 2008. Houssami, N. Journal of Clinical Oncology, July 1, 2008. Volume 26: pp. 3248-3258.



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