Breast MRI screening

It is important for every woman to know that a mammogram will not detect every breast cancer lesion, particularly so for the very early ones. Other factors also come into play. Low Body Mass Index (BMI), previous breast surgery and use of HRT might reduce the sensitivity slightly.

The study quoted at the beginning of this article is not the first one to identify the potential superiority of MRI scanning in this area. The New England Journal of Medicine (NEJM) had carried an article in July 2004 of a study that had shown the value of MRI in screening for breast cancer in high risk women. The latest study is, however, the first of its size and also showing such a dramatic difference. It is possible that as we go forward, MRI might be incorporated or even gradually replaces x-ray mammography as a standard tool for breast cancer screening. This might be particularly important for younger women who might be identified to be at moderate or high risk and who need surveillance.

Currently, experts are in agreement that young women below the age of 40 are not best served by routine mammography, partly because the sensitivity may not be as good, their overall risk is low and also because of the repeated exposure to radiation that this will entail. The risk-benefit sum just doesn’t add up. With MRI scanning (which does not involve radiation), all these obstacles are eliminated in one fell swoop.

Of-course further studies will be required and in many countries, including those in Western Europe, logistical obstacles including easy accessibility to the service will need to be overcome.

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MRI is a valuable alternative to a mammogram