The American Cancer Society recommends magnetic resonance imaging (MRI) in addition to mammography for breast cancer screening. This has been the first update since 2003.
The findings of a study from the NIH showed that MRI detected cancer in the opposite breast with a sensitivity of 91%. That means that the number of women with a positive test result for breast cancer actually had cancer. These cancers were not detected by mammogram.
Screening by MRI is recommended for women at high risk for breast cancer. This includes women with a strong family history of breast or ovarian cancer and women who were treated for Hodgkin disease, according to guidelines from the American Cancer Society. Other subgroups of women in which there is insufficient data to recommend for or against screening include women with a personal history of breast cancer. carcinoma in situ, atypical hyperplasia, and extremely dense breasts on mammography.
MRI is a technique that does not use radiation like mammography. Instead MRI uses large magnets that cause the body’s hydrogen atoms to spin. Atoms spin different rates depending of whether the tissue involved is normal or abnormal. So an MRI can produce a three-dimiensional picture radiologists can use to diagnose cancers and other medical conditions. MRI does not harm the body and is considered safer than CT and most x-rays.
One in 10 women diagnosed with cancer in one breast will develop the disease in the opposite breast. The New England Journal of Medicine concluded MRI can detect cancer in the opposite breast that is missed by mammography and clinical exam at the time of initial breast cancer diagnosis.
Although no imaging tool is perfect in detecting breast cancer, if the MRI is negative, the chance of cancer in that breast is extremely low.
For high risk women, I usually recommend a digital mammogram and ultrasound one year and alternate that with MRI.
Thermograms are becoming more popular as a pre-diagnostic tool. It is not an alternative for mammogram or MRI but it is considered a risk assessment tool. The Colorado Board of Medical Examiners has determined thermograms to be medically significant and used as a pre-diagnostic tool.
If you are 40 or older, talk to your practitioner about which screening test is best for you. Early detection is the best way to prevent breast cancer.