MRIs Detect More Cancer: Other Test Misses Tumors in Breasts

Mar 28, 05:56 AM

Current Headlines: By Catherine Clabby, The News & Observer, Raleigh, N.C.

Mar. 28--Magnetic resonance imaging can detect tumors in breast cancer patients that mammography screenings missed, a new study finds.

That news might expand hope among women battling breast cancer. Early detection and improved treatments are credited with reducing the death toll of breast cancer by 24 percent from 1989 to 2003.

But the findings do not mean that all women need to schedule costly MRI screenings. The study focused on women diagnosed with cancer in one breast after mammograms.

Among that group, MRIs detected cancer in a second breast in 30 out of 969 patients screened across the country. The high-resolution screening process uses atomic changes created with a magnetic field rather than x-ray to "see" inside the human body. It can be more sensitive than a mammogram or a physical exam.

"You don't want to find out a year or two later that you have cancer in a second breast. You might as well go through treatment all at once," said Dr. Etta Pisano, a prominent UNC-Chapel Hill radiologist who helped design the study, detailed today in the New England Journal of Medicine. The research was funded by the National Cancer Institute.

Pisano noted that the tests weren't perfect. The false positive rate was 12 percent during the study. Nor did the study prove that detecting the previously unseen cancers extended the women's lives.

But 60 percent of the detected cancers were invasive, suggesting they could develop into something fatal, Pisano said.

As a result of the findings, Pisano expects UNC-Chapel Hill will alter its screening protocols and begin performing MRIs on all patients found to have cancer in one breast after mammography.

"This doesn't mean don't do mammography. It means, do MRI on top of mammography," Pisano said.

In a related move, the American Cancer Society issued new recommendations that include MRI screenings for women at high risk of breast cancer. It cited numerous international studies that pointed to improved detection of tumors by MRI scans.

The newly reported MRI study results give women at risk one more option to help themselves, said breast cancer survivor Rivka From of Raleigh. She and her two daughters, Carlye and Courtney, all carry the dangerous BRC gene mutation, which increases risk of breast and ovarian cancer.

"This is a brilliant opportunity for women to give themselves permission to be open to medical technology," said From, 55. With her daughters, she started the group Gene Girls to educate others about breast cancer.

But women should be choosy about where they receive specialized breast MRI scans, said Dr. Jay A. Baker, chief of Duke Medical Center's breast imaging division.

Patients are better off with doctors who have the equipment and skills to use MRIs for finding the spot to extract biopsy tissue, and then to perform the biopsy during the same sessions. Otherwise, he said, they would need to obtain two MRI tests, which can cost about $2,000 a piece.

"There just aren't that many places in North Carolina that can do that," Baker said.

He said he hopes that success with MRI screenings will result in more radiology practices buying the right equipment and getting the right training to perform the tests well.

Staff writer Catherine Clabby can be reached at 956-2414 or cclabby@newsobserver.com.

-----

Copyright (c) 2007, The News & Observer, Raleigh, N.C.

Distributed by McClatchy-Tribune Business News.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.