2007-10-31 / Family

Breast MRI: Is it for you?

By Katherine Houstoun

Dr. Mark Vaughn uses MRI technology to help detect breast cancer in women who are newly diagnosed or are at high risk of developing the disease. Dr. Mark Vaughn uses MRI technology to help detect breast cancer in women who are newly diagnosed or are at high risk of developing the disease. When it comes to detecting breast cancer, women have several lines of defense. First are self breast exams, which women can perform on themselves to reveal lumps and abnormalities. Next is mammography, x-ray examinations that every woman over 40 should have performed annually to identify cancer early on.

Now, and increasingly, doctors are also using breast MRI, a relatively new technology that helps them to better detect cancerous cells in a woman's body.

"The studies that have been done show that the sensitivity of breast MRI for detecting breast cancer is higher than mammography or ultrasound," said Dr. Mark Vaughn, the chairman of radiology at Bon Secours St. Francis Medical Center.

Breast MRI, however, is not recommended for every woman, but a rather select group of high-risk patients, as well as women who already have been diagnosed with breast cancer.

"Anybody that has newly diagnosed breast cancer, we're using MRI to evaluate the extent of the cancer before they have their surgery," said Vaughn. "Frequently, we find more cancer than was thought to be there based on the mammogram or the ultrasound. Up to 10 percent of patients may have a second breast cancer."

Additionally, doctors are using breast MRI to screen patients with a family history of breast cancer or genetic markers that increase their risk of having breast cancer.

"We've had patients who have normal mammograms, who have normal exams, who got their MRI because they are higher risk based on their history, and we found cancer," said Dr. Ruth Felsen, a breast surgeon with the Surgical Associates of Richmond. "The data we have does show that MRI detects cancers that otherwise are not seen."

While mammography uses x-rays to examine the density of the breast and seek out precancerous calcium specks, breast MRI uses magnets and radio waves to produce detailed "slices" of the breast that radiologists use to examine blood flow.

"The reason it works for breast cancer is because breast cancer is growing and forming new blood vessels, so it tends to have a very robust blood supply," said Vaughn. "Any part of the breast that has good blood supply is going to show up, and that's why it's very sensitive to find breast cancer, particularly the invasive type of blood cancers."

The sensitive nature of breast MRI technology does have a drawback, however.

"Breast MRI has a tradition of high sensitivity and low specificity, which means it picks up lots of things in the breast, but lots of them are not cancer," explained Dr. Michael Rose, a surgical oncologist with Surgical Associates of Richmond. "That is why routine MRIs are not recommended for the general public."

Breast MRI technology is also expensive; the procedure costs about 10 times as much as mammography. For a select population of women, many physicians agree the time and cost are well worth it.

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