MRI Urged for High Breast Cancer Risk
American Cancer Society Recommends Annual Breast MRI for Very High-Risk Women
WebMD News Archive
Which Women Need Breast MRI? continued...
"The actual number of women seeking MRI screening in addition to
mammography is expected to be much lower than 1 in 50 -- at least for the
foreseeable future," say Debbie Saslow, PhD, ACS director of breast and
gynecologic cancer, and Robert Smith, PhD, ACS director of cancer screening, in
a statement released to WebMD.
Other women may benefit from MRI screening, but there's not yet enough
evidence to include them in the screening recommendation. The ACS says "the
jury is still out" on whether the benefits of MRI screening outweigh the
risks for women with:
- A 15%-20% lifetime risk of breast cancer, based on one of several accepted
risk-assessment tools that look at family history and other factors
- Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH)
- Atypical ductal hyperplasia (ADH)
- Very dense breasts or unevenly dense breasts (when viewed on a
- Previously diagnosed breast cancer, including ductal carcinoma in situ
The new recommendation comes with a warning: Not all doctors' offices have
the proper MRI equipment. Women should not get MRI screening at a practice that
does not also offer MRI-guided biopsies, the ACS warns.
MRI Helps Women With New Breast Cancer
Separately, a new study complements the ACS recommendations. It shows that
for women with a new diagnosis of cancer in one breast, MRI is much better than
mammography for determining whether the other breast carries a cancer.
Constance Lehman, MD, PhD, director of breast imaging at the University of
Washington and Seattle Cancer Care Alliance, was one of the study’s
"This means that instead of those women having another cancer diagnosis
years after their initial treatment, we can diagnose and treat those
opposite-breast cancers at the time of the initial diagnosis," Lehman says
in a news release.
Perhaps more importantly, MRI can all but rule out cancer in the second
"Although no imaging tool is perfect, if the MRI is negative, the chance
of cancer in that breast is extremely low," Lehman notes. "A potential
outcome that we would be delighted to see is fewer unnecessary bilateral
Lehman and colleagues report their findings in the March 29 issue of The
New England Journal of Medicine.