MRI
More Sensitive than Mammography for Women at High-Risk for
Breast Cancer
According to a recent article published in The New England
Journal of Medicine, magnetic resonance imaging (MRI) is more
sensitive than mammography in the detection of early breast
cancer in women at a high risk of developing the disease.
Breast cancer is diagnosed in approximately 250,000 women
annually in the United States. A small portion of these patients
have genetic mutations that put them at a higher than normal
risk for the development of breast cancer. These patients
often undergo regular screening in order to detect the cancer
early, when it is most treatable. Researchers continue to
evaluate which screening method detects the most cases of
breast cancer while providing accurate readings. Screening
methods that have been evaluated include a physical examination,
mammography, ultrasound, MRI, CT scans or PET scans. Results
from previous trials have indicated that MRI is more accurate
than mammography in the detection of breast cancer in women
undergoing surveillance for breast cancer.
Researchers associated with the Magnetic Resonance Imaging
Screening Study Group conducted a clinical trial to directly
compare MRI to mammography in the detection of early breast
cancer. This trial included 1,909 women who were considered
to be at a high risk of developing breast cancer either due
to specific genetic mutations or a strong family history of
breast cancer. The women were screened every 6 months with
a clinical breast examination and every year with mammography
and MRI. The results from mammography and MRI were read independently.
At approximately 3 years of follow-up, the percentage of breast
cancers detected were 17.9% for clinical breast examination,
33.3% for mammography, and 79.5% for MRI. The ability to distinguish
a suspicious result between cancer and a benign mass was 98.1%
for clinical exam, 95% for mammography, and 89.8% for MRI.
The researchers concluded that MRI is a more sensitive screening
method than mammography in women at a high risk of developing
breast cancer. However, MRI is less able to distinguish between
cancer and benign tumors, leading to a higher rate of unnecessary
biopsies. Patients who are at a high risk of developing breast
cancer may wish to speak with their physician about the risks
and benefits of screening with mammography or MRI, or the
participation in a clinical trial evaluating other screening
measures. Two sources of information regarding ongoing clinical
trials include the National Cancer Institute (cancer.gov)
and www.cancerconsultants.com.
Reference: Efficacy of MRI and mammography for breast-cancer
screening in women with a familial or genetic predisposition.
The New England Journal of Medicine. 2004; 351:427-437
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