Annual MRIs Urged Against Breast Cancer

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

(CBS/AP) 
The study looked at nearly 1,000 women recently diagnosed with cancer in one breast but who had no detected cancer in the second breast.

MRIs of the second breast found possible tumors in 121 of the women. Biopsies confirmed cancer in 30 of them.

"This enables us to be able to treat both cancers at the same time rather than delay treatment of the opposite breast cancer," said Lehman.

"It's a pretty striking effect," said Dr. Carl Jaffe of the National Cancer Institute, which sponsored the study.

But it does not suggest MRIs should replace mammograms, which spot calcium deposits better than MRIs do, said Dr. Etta Pisano of the University of North Carolina, one of the study's authors.

"The take-home message of our paper is not, 'Don't get mammography.' It's 'Get MRI and mammography,"' she said.

"As I get my mammograms, I'm also getting MRIs," singer and breast cancer survivor Sheryl Crow said on CBS News' The Early Show.

Crow works with the National Breast Cancer Coalition.

Cancer society officials urged women to carefully choose the clinic that does the MRI. They noted that some facilities that offer MRI lack the expertise and equipment to do an MRI-guided biopsy, meaning the MRI will have to be repeated elsewhere if a possible tumor is found. Breast MRIs should be done at places that do biopsies as well, they said.

This year, the American College of Radiology is expected to start a voluntary accreditation program to help ensure the quality of breast MRI testing, cancer society officials said.

For women at high risk for breast cancer, the test is definitely worthwhile, said Courtney From Hirsch, 26, of Raleigh, N.C. She feels that way despite MRI errors that led to two unnecessary biopsies.

Hirsch's mother was diagnosed with breast cancer in 2004, and Hirsch and her younger sister both tested positive for the BRCA1 mutation. They are among an estimated 22,000 women in the United States who have tested positive in the 10 years since the test became available.

Hirsch said she also has the kind of dense breasts that are problematic for mammograms.

She's had four breast MRIs in the past two years, two of them done as part of biopsies, but fortunately nothing has been found.

There are downsides, she said: Lying in an MRI scanner for an hour or more can be uncomfortable. Her family has paid $10,000 out-of-pocket for uncovered costs from mammograms, MRIs and biopsies in the last two years. It can be difficult to schedule "magnet time" at the busy UNC cancer centre where she gets her screenings. False positives can be frightening, and one of the biopsies left scarring that she said was visible at her February wedding.

"I'd rather have as many scars as I need to on my body to prevent getting cancer," she said.

[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?

[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.

[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?

[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.

[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.

[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.

[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.

[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.

[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.

[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.

[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.