Study challenges routine use of MRI scans to evaluate breast cancer

June 26, 2009

Reviewing the records of 577 breast cancer patients, Fox Chase Cancer Center researchers found that women with newly diagnosed breast cancer who receive a breast MRI are more likely to receive a mastectomy after their diagnosis and may face delays in starting treatment. The study demonstrates that, despite the lack of evidence of their benefit, routine use of MRI scans in women newly diagnosed with breast cancer increased significantly between 2004 and 2005, and again in 2006.

The study is online now and will be appearing in the August edition of the .

"We have yet to see any evidence that MRI improves outcomes when used routinely to evaluate , and yet more and more women are getting these scans with almost no discernable pattern," said Richard J. Bleicher, M.D., F.A.C.S., a specialist in surgery at Fox Chase. "For most women, a breast MRI prior to treatment is unnecessary. MRI can be of benefit because it's more sensitive, but with the high number of false positives and costs associated with the test, more studies are needed to determine whether MRI can improve outcomes in women who have already been diagnosed with breast cancer."

Bleicher and his colleagues reviewed the records of 577 breast cancer patients seen in a multidisciplinary breast clinic where they were evaluated by a radiologist, pathologist, and a surgical, radiation, and medical oncologist. Of these patients, 130 had MRIs prior to treatment.

"Those who received an MRI had a three-week delay in the start of their treatment," said Bleicher. "But more strikingly, we're concerned that the well-documented false-positive rate with MRIs may be leading-or misleading-women into choosing mastectomies."

Bleicher said many of the women would have been candidates for a lesser procedure known as a . "There are a few reasons why we may be seeing higher mastectomy rates when MRIs are performed. An is very sensitive, leading to a high number of false-positive findings. Rather than having a biopsy to see if those findings are real, women and their doctors may choose mastectomy out of an abundance of caution. Other studies have demonstrated that this often represents over-treatment because many of the mastectomies are later proven by pathology to have been unnecessary."

The study also revealed that younger women were more likely to have an MRI. "In our analysis, that trend, surprisingly, didn't correspond with various breast cancer risk factors, such as a family history of breast or ovarian cancer, nor with the characteristics of their disease," explained Bleicher.

Another research conclusion included the failure of MRI's to help surgeons decrease positive margins during surgery, another hypothesized benefit of MRI.

"MRI is a valuable tool in some women, and these findings do not negate their value in screening women at high risk, such as those with genetic mutations. Without evidence, though, that routine pre-treatment MRI improves a woman's outcome, its disadvantages suggest that it should not be a routine part of patient evaluation after diagnosis," said Bleicher. "Greater efforts to define MRI's limitations and use are needed."

Source: Fox Chase Cancer Center (news : web)

Related Stories

Recommended for you

Study uncovers potential 'silver bullet' for preventing and treating colon cancer

July 26, 2017
In preclinical experiments, researchers at VCU Massey Cancer Center have uncovered a new way in which colon cancer develops, as well as a potential "silver bullet" for preventing and treating it. The findings may extend to ...

Compound shows promise in treating melanoma

July 26, 2017
While past attempts to treat melanoma failed to meet expectations, an international team of researchers are hopeful that a compound they tested on both mice and on human cells in a petri dish takes a positive step toward ...

Understanding cell segregation mechanisms that help prevent cancer spread

July 26, 2017
Scientists have uncovered how cells are kept in the right place as the body develops, which may shed light on what causes invasive cancer cells to migrate.

Study may explain failure of retinoic acid trials against breast cancer

July 25, 2017
Estrogen-positive breast cancers are often treated with anti-estrogen therapies. But about half of these cancers contain a subpopulation of cells marked by the protein cytokeratin 5 (CK5), which resists treatment—and breast ...

Breaking the genetic resistance of lung cancer and melanoma

July 25, 2017
Researchers from Monash University and the Memorial Sloan Kettering Cancer Center (MSKCC, New York) have discovered why some cancers – particularly lung cancer and melanoma – are able to quickly develop deadly resistance ...

Physical activity could combat fatigue, cognitive decline in cancer survivors

July 25, 2017
A new study indicates that cancer patients and survivors have a ready weapon against fatigue and "chemo brain": a brisk walk.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

E_L_Earnhardt
not rated yet Jun 26, 2009
X-ray mastectomies accelerate mitosis and are a leading cause of breast and lung cancer! They should be stopped if it takes an act of Congress!
"Lumpectomy", or even mastectomy, is a far better route! Lung cancer is less likely to follow!

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.