New Guidelines Issued
for Breast MRI
By Michelle R. Straka, M.D.

Continued from Home Page

Recently, studies have shown that breast MRI has higher sensitivity than mammography for the detection of breast cancer. However, breast MRI is expensive and generates more false-positive results, leading to additional breast biopsies and follow-up exams.
To assist women in the proper use of this technology, the American Cancer Society has issued new guidelines. They now recommend yearly screening breast MRI and mammography for a select group of women at high risk for developing breast cancer.
These include those with a known genetic mutation (such as BRCA1 or BRCA2), a first-degree family member (e.g. mother or sister) with a known genetic mutation, a genetic syndrome associated with an increased risk of breast cancer (such as Li-Fraumeni syndrome, Cowden's syndrome or Bannayan-Riley-Ruvalcaba syndrome), a history of radiation therapy to the chest between the ages of 10 and 30 years, or a calculated lifetime risk of breast cancer of greater than 20-25 percent.
The lifetime risk of breast cancer is also elevated in women with breast cancer in a male relative, two or more first-degree relatives with premenopausal breast cancer, one family member with a history of two or more breast cancers, or one relative with both ovarian and breast cancer.
The indications for screening breast MRI currently do not include women with dense breast tissue, women with a previous personal history of breast cancer or those with a personal history of an atypical breast biopsy. These are conditions that carry an intermediate risk of breast cancer.
As opposed to screening MRI, which is done when there are no breast symptoms or complaints, diagnostic MRI is performed in certain specific clinical situations. Some of these reasons are newly diagnosed breast cancer, suspected implant rupture, nipple retraction, bloody or clear nipple discharge or a breast lump. In some cases of breast cancer, the effects of chemotherapy may be assessed with serial MRI exams. .
Dr. Michelle R. Straka, is a radiologist with Weinstein Imaging Associates and is active in the women’s imaging community. For more information, visit www.weinsteinimaging.com

Breast Cancer At A Glance
• One in every eight women in the United States develops breast cancer.
• The causes of breast cancer are not yet fully known although a number of
risk factors have been identified.
• There are many types of breast cancer that differ in their capability of spreading
(metastasize) to other body tissues.
• Treatment of breast cancer depends on the type and location of the breast cancer,
as well as the age and health of the patient.

Source: www.medicinenet.com and the National Cancer Institute (www.cancer.gov).

For more articles, download the Summer '08 issue (PDF)