Annual MRIs Urged Against Breast Cancer

Exam Can Pick Up Cancers Missed By Mammograms, And Are Recommended For Women At High Risk

(CBS/AP)  Women with an unusually high risk of developing breast cancer should get annual MRIs as well as mammograms, the American Cancer Society advises in new guidelines.

And a new medical study suggests that all women newly diagnosed with breast cancer should get MRIs, too. The scans revealed cancers in the opposite breast that were missed by ordinary mammograms in 3 percent of these cancer survivors.

"We have a very powerful tool in MRI that can detect cancers that previously have not been identified by mammography or clinical breast exam," lead researcher Dr. Constance Lehman of the University of Washington Medical Center told CBS News correspondent Barry Bagnato.

The study came out after the cancer society developed its guidelines, which are the first to recommend MRI for screening women who show no signs of cancer.

The guidelines are directed at symptom-less women age 30 and older who have a mutation in the BRCA1 or BRCA2 genes; those who were treated for Hodgkin's disease; or those with a strong family history of the disease, such as women with two or more close relatives who had breast or ovarian cancer or who have a close relative who developed breast cancer before age 50.

As many as 1.4 million women fall into the affected group in the U.S., according to an American Cancer Society estimate.

Doctors usually screen for breast cancer using mammography, an X-ray technique that can spot dense masses like tumors.

MRI, or magnetic resonance imaging, makes more detailed images with a magnet and radio waves — but without radiation. MRIs are better at showing increased or abnormal blood flow in the breast, a sign of early cancers not visible on a mammogram. They also are better than mammograms at detecting cancer in women with dense, non-fatty breasts.

Dana Kaplan survived breast cancer twice, and an MRI, not a mammogram, detected her cancer the second time, reports CBS News correspondent Kelly Wallace.

"I think the MRI saved my life," Kaplan said. "I think if it were not for the MRI, I may not be sitting here."

But MRI screening is not being recommended for most women. One reason is the test's error rate, which can lead to unnecessary biopsies.

Another is the high cost. While a mammogram costs roughly $100 to $150, an MRI can cost $2,000 or more at some medical centers, experts said.

"It's very, very expensive," said Robert Smith, the cancer society's director of cancer screening.

Insurance often doesn't cover them, points out Bagnato.

Insurers generally follow government guidelines, but the cancer society guidelines could prove influential, according to experts.

The new guidelines were being announced Wednesday, the same time the New England Journal of Medicine was releasing a national study that suggests women who have cancer diagnosed in one breast should get an MRI in the other.

[momkowatch5]

YES! YES! Finally! I was an oncology research nurse in June 2003, just turned 40 and diagnosed with breast cancer by lumpectomy of a tumor that did not show up on MRI. I saw a study in an oncology mag. about breast MRI and thought, "that is for me." I had to ask 4 different doctors specializing in oncology but finally got one. It showed up 2 other spots of cancer in the same breast that ultrasound, mammogram and breast exams by 5 specialists had missed. Whenever I went to oncology conventions I also headed for any researcher I could get a hold of and asks for more studies on this! Finally after 3 and 1/2 years! I'm ecstatic!
I was also BRCA 1 and 2 negative. However that test can have a 10-12% false negative rate.

[liondoctr]

Oh yes one more earth shattering news, and what insurance company is going to cover this?????today's insurance is so high to begin with that they have so many co-pays and so on they make it impossible to take care of yourself without going broke.

[barbaraf4]

I have heard it said (by politicians, pharmaceutical execs and other crooks) that health is a commodity. If you can afford it, you can have it; if not, then you cannot have it.

And just a reminder: we, the taxpayers, are paying for all that wonderful insurance that covers everything (including rehab, no doubt) for our politicians and their families. For Life.

[gwagener]

Barbaraf4 wrote:
And just a reminder: we, the taxpayers, are paying for all that wonderful insurance that covers everything (including rehab, no doubt) for our politicians and their families. For Life.

Not true. The Congress is eligable for the same health care system as the Civil Service. It's a good system, but it does not pay for everything and does not pay for drug rehab. It is a pretty good deal, but it's not free because the recipiant pays a third of the premium. I suppose state politicians are probably on their state Civil Service health system.
The president and vice-president get full coverage for everything. That's a result of the country being very embarrased by President Grant dieing in poverty.

[godseyesore-2009]

Once again we see how the wealthy will be able to access health care while the poor will die...thanks to idiots in government (usually republicans) who won't support healthcare for all and, as a right of citizenship.

[cathaleen]

First of all you just can't walk in and ask to get an MRI. There are steps you have to go thru.
First you go to your primary (that's a co-pay) and once the doctors find out that MRI's are hot commodities, they'll have a slew of test (more money) set up for you even before they send you for an MRI. By then you'll need a few valium
because that will be another bill - insurance plans to not fully cover MRI's.

[momkowatch5]

My MRI was covered by my insurance in 2003. At the clinic where I worked there were also state aid patients and theirs were covered as well.

The important thing is to get a copy of your mammogram report and if it says, "dense breast tissue", then it's not telling you much and you need further testing for clarification.

[godofredo29]

For my money, an MRI is roughly equivalent to those x-ray glasses they used to sell in the comic books. When they are employed on soft tissue, they are virtually useless. One was used on a friend of mine prior to abdominal surgery to repair a blockage. The purpose was to determine if her cancer has traveled to her abdomen. After the MRI, doctors concluded that it hadn't. They performed the surgery, found cancer throughout the abdomen, performed the equivalent of a live autopsy and she died an agonizing death in the weeks that followed trying to both battle the cancer and recover from the devastating surgery.

[godofredo29]

You know, if medicine were as aggressive about mandating testicular ultrasounds for at risk men, the diagnosis and cure rate would approach 100%. They're inexpensive and nearly risk free. So, what's the hangup?

[lobular]

You need to define Ductal cancer which forms a lump that a mammoram and self exam detects. Lobular cancer grows in a line inside a milk duct etc. and cannot be felt, seen on a mammogram or a sonogram. Telling women that getting an annual mammoram is fine is not true. I had a clear mammogram on 12/27 and found out on 1/5 that I have stage IV invasive lobular breast cancer that has already spread to all of my bones, especially my spine. I am shocked, scared to death. The last mammogram was clear on 12/27/06. I found out because I went to my doctor for a "bad" back. They did an MRI
something altering my spine only caused by a malignancy somewhere. It was found to be breast cancer. An MRI would have caught it in time. Mine is not curable and I only have a 25-35% chance of living 5 years according to the statics. I didn't even have a chance to fight it. I don't think its responsible of you to just report on the ductal cancer and tell women they are "safe" if they get an annual exam. I can't tell you how this affects your life, your mental state, your outlook on the future, and how you worry about your family and how to make sure they are ok financially (I am the primary wage earner and carry the insurance). Don't make another woman go through this - tell them to ask for an MRI even if there is no history of cancer in their family, just like mine.

[rock1gj]

When the MRI test for breast cancer is so expensive, and still invasive (RF and Magnets rearranging protons) and is being promoted for its ability to show blood flow, it is really hard to understand why infrared thermography (thermology) is not being recommended as well. This is especially disturbing when infrared thermal imaging is truly non-invasive, efficient and comfortable to administer. It is an important physiological test, showing the blood flow and heat emissions in the areas of concern - fundamental medicine! The research to support the use of thermal imaging in all areas of medicine is extensive, and the use for adjunctive breast evaluations has been around for decades - i.e. Isard et al, Albert Einstein Med.Ctr., Philadelphia; and more recently Keyserlingk, Villa Marie, Ontario Canada; Keith LG, et al, Northwestern U. Med. School. Why are physicians not being educated about this other imaging option that is low cost, and readily available for all women?