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The high sensitivity of MRI often detects additional foci of otherwise clinically irrelevant tumor cells in the same or the opposite breast.These MRI findings may lead to overtreatment in the form of unnecessary mastectomies or radiation and chemotherapy.

Magnetic resonance imaging is very beneficial in diagnosing early breast cancer

Breast cancer is the second most common cancer found in females and is second in the list of causes behind all the cancer deaths. Going by the statistics, one in every eight women develops breast cancer in her lifetime and one in every thirty three women affected by breast cancer succumbs to her disease. Being aware of the risk factors and then taking well informed decisions right from the stage of diagnosing the disease to following the correct course of treatment, is the only way of lowering the mortality associated with breast cancer. 

The first step in the early detection of breast cancer is self examination. All females are advised to routinely examine their breasts at regular interval and report to their doctor in case they notice any abnormality. After a thorough clinical examination, the next step is mammography. In case, mammography detects anything unusual, the patient is advised to undergo magnetic resonance imaging (MRI) of the breasts. Breast MRI is very beneficial in diagnosing early stage breast cancer. It helps to screen both the breasts at the same time as it prevents the compression of the breasts and allows them to be positioned bilaterally. It helps in establishing the exact size of the tumor and its extent as a volumetric analysis of breast tissue can be done using different color codes. Breast MRIs are so beneficial in diagnosing early stage cancer that in certain countries, like the USA, they are carried out almost routinely in all patients suspected of having breast cancer.

MRI findings may lead to overtreatment

The high sensitivity of MRI often detects additional foci of otherwise clinically irrelevant tumor cells in the same or the opposite breast. These MRI findings may lead to overtreatment in the form of unnecessary mastectomies or radiation and chemotherapy to the other breast.

While breast MRI is the best diagnostic tool available today to assess the extent of advanced breast cancer and the response of tumor cells to chemotherapy, the same cannot be said about cases with early breast cancer. Studies show that almost 19% of women who had undergone surgical intervention for early breast cancer had to return for a second surgery irrespective of whether they had undergone MRI or not. This clearly shows that MRI does not offer any significant benefit to patients of early breast cancer. Moreover, there is no evidence till date to prove that the overzealous treatment in the form of more mastectomies can save a person from death due to cancer.

MRI scans use strong magnetic fields and radio waves which can detect even small, harmless growths. Such results are termed as ‘false positive’ and account for about one in every four of the cases detected by MRI. Removal of such growths does not, by any means, change the patient’s prognosis or chances of her survival following the standard treatment protocol. Yet, these MRI findings may lead to overtreatment and account for about 7-8% increase in the total number of patients undergoing mastectomies for breast cancer.

The ideal method of managing early breast cancer and avoiding unnecessary breast surgeries is by drug treatment under regular monitoring through mammography and ultrasound. The use of breast MRI should be restricted to advanced cases and to assess the response to chemotherapy.

  • Stephen Adams. October 24, 2010. MRI Scans ‘Lead to Unnecessary Breast Surgery’ Says Surgeon. The Telegraph.