Breast MRI
Turnersville and Voorhees
The breast cancer death rate has been declining since 1990, not only due to advances in treatment, but also because of early detection, which improves the opportunities to cure the disease. Regular screenings with mammography is an important and significant contributing factor.
Mammograms are still an important screening tool. However, the American Cancer Society now recommends the addition of magnetic resonance imaging (MRI), along with annual mammography, particularly for women at high risk for breast cancer.
Why MRI?
MRI uses a magnetic fields instead of radiation to create a breast image, MRI improves the search for malignancies because it provides better soft tissue contrast. Previously used principally as a follow-up test for suspicious mammograms, MRI now is increasingly considered as a “first-line” technology for recognizing tumors.
Studies show value of MRIs in cancer detection
According to Harvard Women’s Health Watch, “MRI’s value in detecting breast cancer is most evident in studies involving women at high risk for the disease.” The New England Journal of Medicine reported a study by Dutch researchers that showed that in a study of 1,900 women over a three-year period mammograms detected 18 cancers but missed 22. MRI, on the other hand, found 32 cancers and missed only eight that were detected by mammography. The journal Radiology reported a 2007 study undertaken at six U.S. medical centers that compared MRI, mammography and ultrasound in 171 women over age 25 whose lifetime breast cancer risk was 20% or more. Six cancers were detected out of 16 biopsies; mammography detected only two, ultra sound only one, while MRI detected all six. Mammography and ultra sound did not find any tumors that MRI missed. And only MRI discovered the four cancers found in women with dense breasts.
Who could benefit from breast MRI tests?
The American Cancer Society recommends an annual MRI—in addition to a yearly mammogram—for women who have a 20% or greater lifetime risk of breast cancer. The following standards are used by most medical experts in determining which women are in the high-risk category:
- A genetic risk determined by a positive test for mutations in the BRCA1 or BRCA2 genes. If you have not been tested, a close relative (parent, sibling or child) who has tested positive for cancer.
- A lifetime risk of 20-25%. The National Cancer Institute offers a risk calculator at 222.cancer.gov/bcrisktool.
- Hodgkin’s disease survivors, who have an almost 50% risk of breast cancer.
- Those who received radiation therapy to the chest between the ages of 10 and 30.
- Women with Li-Fraumeni familial cancer syndrome or other rare genetic disorder that cause mutation in genes that reduce tumor growth or cause chromosomal damage, thus increasing susceptibility to breast cancer.
Are you a candidate for an MRI?
Those uncertain if they are high risk or average risk for breast cancer should review their situations with their physicians. Family history is important in determining risk for breast cancer. Changes with age may alter your risk factors. Annual mammogram and clinical breast examinations are still the best first steps in the detection of early-stage, highly treatable cancers or most women over 40.
Selecting an imaging center
Choose an imaging center that offers MRI-guided biopsies so that if a suspicious mass is discovered you won’t have to go to a separate healthcare facility.
Having a breast MRI
- Remove any metals such as jewelry, glasses and hearing aids.
- A front-opening robe will be provided.
- A small catheter will be inserted into your arm and a contrast agent (gadolinium) that highlights areas of abnormal vascularity will be injected.
- You will lie down on your stomach on the MRI table. You will put your arms around the pillow supporting your head. Both breasts will be in a cushioned recess that holds the signal receiver (breast coil).
- The table will be moved into a large tube that houses the magnet
- You will be asked to lie still for up to 15 minutes while the images are created by the computer.
- If you are anxious or uncomfortable in small spaces, ask for music or a video to help you relax.
Current breast cancer screening by organization*
| Organization |
Guidelines |
| American Cancer Society |
Annual mammogram for women ages 40 and over.
Clinical breast exam every two to three years for women ages 20 to 40, and annually for women ages 40 and over.
Annual breast MRI for women whose lifetime risk of breast cancer is greater that 20%. Women whose risk is 15% to 20% should discuss the risks and benefits of annual breast MRI with their doctor to determine whether it is appropriate for them.
|
| National Cancer Institute |
Mammogram every one to two years for women ages 40 and over.
Clinical breast exam every one to two years.
|
| U.S. Preventive Services Task Force |
Mammography with or without clinical breast examination every one to two years for women ages 40 and over.
|
* All of the groups consider breast self-exam, which has not been demonstrated to save lives, to be optional. They also set no upper age limit on mammography, instead advising annual mammograms for any woman who can realistically expect to live at least five more years and would be a candidate for treatment should she be diagnosed with breast cancer.
