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Breast Cancer Health Center

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MRI and Outcomes for Early Form of Breast Cancer

Study found that the costly scan didn't lead to less recurrence for ductal carcinoma in situ

continued...

Since there are no established clinical guidelines on the use of MRI for women with newly diagnosed breast cancer, it tends to vary by hospital and by surgeon, the researchers said. They pointed to a recent survey of U.S. surgeons showing that 37 percent regularly order MRIs for patients with DCIS.

One expert said the findings weren't unexpected.

"In the United States, among women diagnosed with breast cancer and many of their physicians, there is the perception that more testing is always better and that all tests provide meaningful information. This is not always the case," said Dr. Elisa Port, chief of breast surgery and co-director of the Dubin Breast Center at the Mount Sinai Medical Center in New York City.

"As with any other test, for MRI there is no 'one size fits all,' and MRI should not be automatically performed in patients with newly diagnosed breast cancer, but should be performed selectively and appropriately based on patient and physician decision making," Port said.

Not everyone agreed with the study results, however.

Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital in New York City. She said the study had design flaws that might skew the results.

"Patients were not randomized and, as would be expected, women who underwent MRIs had higher-risk disease, which would increase their risk of recurrence," she said. "There was no standardization as to who received a preoperative MRI or not, and women who ended up needing mastectomies -- perhaps because of an MRI finding -- were excluded. This creates a large amount of bias and minimizes the findings."

"Perhaps the conclusions may prove to be true, but a randomized study needs to be carried out before we can say with confidence that preoperative MRIs are not beneficial," Bernik said.

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