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MRI Detects Early Breast Cancer Cells

Study Shows MRI Screening Has High Detection Rate of Precancerous Cells
WebMD Health News

Aug. 9, 2007 -- MRI screening has been considered less sensitive than mammography for detecting precancerous cells in the breast which are confined to the milk ducts, but a new study suggests the opposite is true.

Breast MRI detected 92% of surgically confirmed cases of ductal carcinoma in situ (DCIS) in the German study, compared to a 56% detection rate for mammography. Because DCIS often develops into invasive breast cancer, it is almost always treated with surgery to remove all of the DCIS tissue.

The study appears in the Aug. 11 issue of the journal TheLancet.

In the U.S., magnetic resonance imaging (MRI) is currently recommended in addition to an annual mammogram only for very high-risk women. But researcher Christiane K. Kuhl, MD, of the University of Bonn, says the new findings could mean a much broader use for breast MRI screening in the future.

"I would go so far as saying this is the beginning of the death of mammography, but it is going to be a very, very slow death," Kuhl tells WebMD.

"It will take many years before we have enough randomized prospective trials to fully confirm our findings and enough radiologists who are qualified to perform MRI to screen for breast cancer."

The Problems With MRI

Debbie Saslow, PhD, of the American Cancer Society, is unconvinced. She tells WebMD that mammography is, and will remain, the screening tool of choice for breast cancer for at least the next decade.

"We will see more technologies like MRI approved for use along with mammography," she says. "But I don't know anyone who believes that any of these technologies are candidates for replacing mammography."

Availability and cost are presently two important obstacles to a broader use of breast MRI in the U.S., but they are not the only ones, Saslow says.

A breast MRI can cost $1,000 to $1,500 -- ten times the typical cost of mammography. And there are currently not enough radiologists trained in the procedure or dedicated breast MRI machines to provide screening to a larger population of women.

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