According to a recent presentation at the 39th annual meeting of the American Society of Clinical Oncology, magnetic resonance imaging (MRI) appears superior to mammography and ultrasound imaging in early detection of breast cancer in high-risk women.
Individuals with strong family histories and/or mutations within the BRCA1 or BRCA2 genes have a high risk of developing breast cancer within their lifetime. Women with these mutations have to make a decision as to whether preventive surgery or frequent monitoring for the development of breast cancer will provide the most reassuring option for them. Self breast exams, mammography and ultrasound imaging are all frequently used for monitoring of breast cancer. However, since young women have more dense breasts, mammography often cannot pick up small cancers.
Researchers from Germany recently conducted a clinical trial to compare the effectiveness of magnetic resonance imaging (MRI), ultrasonography or mammography in women who were at a high risk of developing breast cancer. This trial included women with a strong family history of breast cancer or women who had mutations within the BRCA1 and/or BRCA2 genes. Screening including MRI, ultrasound and mammography were initiated at the age of 30 years or 5 years younger than the onset of family disease. The detection rate of small cancers was 96.1%, 47% and 42.8% for MRI, ultrasound and mammography, respectively. The ability to distinguish between cancer and non-cancerous masses occurred 95.1%, 94.3% and 88.4% of the time in MRI, ultrasound and mammography, respectively. MRI screening resulted in the fewest unnecessary biopsies.
These results indicate that MRI has the highest detection rate of small cancers and leads to the lowest rate of unnecessary biopsies compared to ultrasound and mammography in young women at a high risk of developing breast cancer. The researchers suggest that MRI is superior to ultrasound and mammography in this group of women and should be considered to replace mammgraphy as the most effective screening measure. Patients at a high risk of developing breast cancer may wish to speak with their physician about the risks and benefits of MRI screening.
Reference: Kuhl C, Schrading S, Leutner C, et al. Surveillance of “high risk” women with proven or suspected familial (hereditary) breast cancer: First mid-term results of a multi-modality clinical screening trial. Proceedings from the 39th annual meeting of the American Society of Clinical Oncology. Plenary Session. Abstract #4. May 2003.