http://www.cnn.com/2003/HEALTH/conditions/06/02/mri.mammograms/index.html

Study touts MRIs in detecting breast cancer

Monday, June 2, 2003 Posted: 2:17 PM EDT (1817 GMT)

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(CNN) -- Women are advised to get mammograms every year, but a new study says a better screening tool is available for those at high risk of breast cancer.

Research presented at this week's meeting of the American Society of Clinical Oncology in Chicago, Illinois, shows that an MRI, or magnetic resonance imaging, can help find breast cancers missed by mammograms in women at high risk for the disease.

In the Dutch study of nearly 2,000 high-risk women, mammograms detected 36 percent of the women's tumors, while MRIs picked up 71 percent.

The differences were even more dramatic for invasive cancer (cancer that has started to spread to surrounding tissue). Mammograms caught 26 percent of invasive cancers and MRIs 83 percent, according to the study.

An MRI is a procedure that uses powerful magnets and radio waves to look inside the body.

Megan Neff, 30, benefited from such a procedure.

Last month, radiologists saw something suspicious when they did imaging of Neff's breasts. She had had a mammogram, but it didn't detect cancer. However, the MRI did.

"I think the bottom-line message is to be vigilant," said Neff, who has a family history of cancer.

"If you don't know [your family history], you won't realize that you are at greater risk, and the MRI could possibly help."

Dr. Mitchell Schnall with the University of Pennsylvania said that once a week he detects breast cancer with an MRI that a mammogram had not found. He said MRIs are a useful screening tool for high-risk women.

"If my wife were to be in that category, I would certainly have her get screened with an MRI," said Schnall, who has no connection to the study. "Picking up breast cancer early is the best chance for a cure from the disease."

But experts warn against thinking that all women should get MRIs. They said that this type of screening should be done on high-risk women. Compared with mammograms, MRIs have more false positives, experts said. The MRIs detect cancer when there is none, and women end up having unnecessary biopsies.

Schnall said MRIs shouldn't replace mammograms since the latter do pick up some cancers that MRIs don't.

The largest study of its kind, the Dutch research could have major implications for how high-risk women are screened for breast cancer.

Recently, the American Cancer Society updated its recommendations on breast cancer screening and included new research about MRIs.

Guidelines include educating women at high risk for breast cancer and the potential benefits from the use of breast ultrasound or an MRI.

The organization's recommendation for annual mammograms remained the same: Women of average risk should have their first mammogram at age 40, and those at high risk should start at 30.

CNN Medical Correspondent Elizabeth Cohen contributed to this report.