The past two years have seen a dramatic increase in the number of MRIs being performed on the breasts of women newly diagnosed with an early-stage breast cancer. In fact, women are now arriving at breast centers actually requesting that an MRI scan of their breasts be done.
Unfortunately, a new review of hundreds of such MRI results has revealed that they actually may not be as helpful as health professionals were expecting. The hope was that MRIs could assess the breast tissue better than a mammogram can and so help ensure that a cancer is limited to one tumor and not to several -- one small tumor can be surgically treated with lumpectomy, whereas multiple tumors in the breast call for mastectomy surgery.
The study's results showed that an MRI, in spite of costing around $1,400 on average (meaning some places charge even more than that), didn't improve surgical planning or reduce follow-up surgery or lower the risk of local recurrences. Those who have been advocating for this new way of using the MRI couldn't have anticipated such a total washout.
The reason the MRI has not turned out to be a universal solution to breast imaging is that the procedure is highly sensitive but not very specific. This means it is so sensitive that it can see and photograph all sorts of things in the breast but it can't necessarily tell you what those things are.
And when a woman becomes saddled with an unhelpful MRI that lacks clear answers and can give a doctor more questions than answers, she can be catapulted into a completely new series of biopsies and other scans, as well as a prolonged episode of anxiety even worse than when she found out she had breast cancer. Some women, due to the stress of it all, request mastectomy solely out of fear.
So let's just slow down, everyone!
We first must find out for sure when an MRI should be used and when a mammogram is all that's needed. Radiologists have long known that dense breast tissue makes it difficult for a mammogram to assess the extent of a tumor; women with this type of breast tissue and a high risk of getting breast cancer are the ones who should consider getting an MRI, along with a mammogram. And these women next need to make sure that the radiologist who will read their MRI is expert at doing so.
