MRI Detects Breast Cancer Early in High-Risk Women
MRI significantly improves the chances of early breast-cancer detection among women who are at high risk of developing the disease, according to a study in the New England Journal of Medicine. Click here for study.
The study found that MRI detected almost twice as many cancers as mammography did in women whose cumulative lifetime risk of breast cancer was 15 percent or more due to family or genetic predisposition to the disease.
The study reported that the sensitivity of MRI for these patients was 71 percent while that of mammography was 40 percent.
The study said that the breast cancer detection rate for those women in particular who carry a faulty gene that makes them more vulnerable to breast cancer was 26.5 per 1,000 woman-years of follow-up vs. 9.5 per 1000 years of follow-up for high-risk patients overall. Some 50-85 percent of women with mutations of the BRCA1 or BRCA2 gene ultimately develop breast cancer.
For women of average risk, mammography has been widely recognized as life-saving and cost-effective. But mammography has more difficulty in detecting tumors in younger women, who have denser breasts than older women, and especially in women who are carriers of a BRCA gene mutation. MRI is highly sensitive in breast imaging and is unaffected by breast density.
The study also found that while MRI identifies more cancers, it also creates more false alarms, leading to additional unneeded examinations and unneeded biopsies. In an accompanying editorial, Laura Liberman, M.D., from Memorial Sloan Kettering Cancer Center in New York, concluded that the ability to catch hidden cancers in high-risk patients may well outweigh the false alarms. She also called for additional studies. Click here for editorial.
1"Efficacy of MRI and Mammography for Breast Cancer Screening in Women with a Familial or Genetic Predisposition," Kriege M, et. al., New England Journal of Medicine, 2004; 351: pp. 427-437
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