 (HealthDayNews) -- If you want the best available screening for breast cancer, should you skip a mammogram and go for the latest technological innovation -- magnetic resonance imaging?
You might consider it if you're at high risk for breast cancer, according to cancer specialists. But for most women, experts say, a mammogram is probably still the best option.
"Our research shows that women at high risk for breast cancer would benefit from an MRI, but women at low or normal risk would not," Dr. David Dershaw, director of breast imaging at Memorial Sloan-Kettering Cancer Center in New York City and co-author of a study comparing the two, told HealthDay.
Women at high risk include those who have a close family member with the disease, who started menstruating before age 12, who went through menopause after age 50, who have no children or who gave birth after age 30, according to the American Cancer Society. Certain genetic factors also increase the risk for one out of 10 women.
Dershaw's study, which appeared in the journal Cancer, found that an MRI is more sensitive than a mammogram in detecting abnormalities in breast tissue. But there are several downsides to using an MRI for routine testing for women who are not at high risk for breast cancer.
Most problematic is that its ultra-sensitivity to all abnormalities in breast tissue, malignant or not, means an increase in the risk for false-positive results, which can lead to unnecessary biopsies. Biopsies, in turn, result in scar tissue that can compromise future imaging.
"The more scar tissue you have, the more difficult it can be to sort out what's going on," New York University oncologist Dr. Julia Smith told HealthDay.
Further, she said, the psychological and emotional trauma of a false-positive diagnosis cannot be underestimated.
"You don't want to be unnecessarily putting women through something this dramatic unless it's going to have a positive impact on their health and their health care," she said.
Also a consideration is that an MRI costs considerably more than a mammogram, as much as $1,000 compared with approximately $100 or less for mammograms. And insurance often does not cover the use of MRI as a diagnostic tool, according to breastcancer.org, a nonprofit group that provides up-to-date information about breast cancer.
Finally, an MRI does not show calcifications -- tiny deposits that can indicate breast cancer, according to breastcancer.org.
In his study, Dershaw and his colleagues reviewed records of 367 women with normal risk factors for the disease who had no cancers detected in routine mammograms. When the same women had MRIs, 89 women were found to have "probably benign" lesions.
After a second follow-up MRI, within about 11 months, 20 of those women had biopsies. Of those 20 women, malignancies were found in nine, which constituted 10 percent of the original 89 diagnosed with "probably benign" lesions, or two percent of the original 367.
On the Web
To learn more about different methods for detecting breast cancer and the importance of screening, visit breastcancer.org.
SOURCES: HealthDay News Service; David Dershaw, M.D., director of breast imaging, Memorial Sloan-Kettering Cancer Center, New York City; Julia Smith, M.D., oncologist and hematologist, New York University Medical Center, and clinical assistant professor, New York University School of Medicine, New York City; June 15, 2003, Cancer; breastcancer.org, updated Feb. 20, 2004; American Cancer Society, Web site updated June 11, 2004
Publication Date: June 30, 2004
Author: Janice Billingsley
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