Breast cancer

10 August 2007

Scans may help prevent cancer

MRI scans may offer a new way to detect breast cancer at its earliest stages and perhaps even prevent cancer among high-risk women, European researchers said on Thursday

MRI scans may offer a new way to detect breast cancer at its earliest stages and perhaps even prevent cancer among high-risk women, European researchers said on Thursday.

Details of a German study show that magnetic resonance imaging was better than standard mammograms, a type of X-ray, at detecting a non-malignant tumour called ductal carcinoma in-situ, or DCIS.

This could give surgeons time to remove the lesion before it can turn cancerous.

The findings, published in the Lancet medical journal, suggest that MRI should be tested in more women to see if it should become a standard screening tool, said Dr Carla Boetes and Dr Ritse Mann of the Radboud University Nijmegen Medical Centre in the Netherlands.

"Although these results were unexpected, the pathophysiology of breast cancer provides ample justification for the findings," they wrote in a commentary in Lancet.

Results show nine percent of women have DCIS
Boetes and Mann noted that autopsy results show that about nine percent of women have undetected DCIS, and that almost all malignant breast cancer is believed to start out as DCIS.

"MRI should thus no longer be regarded as an adjunct to mammography but as a distinct method to detect breast cancer at its earliest stage," they wrote.

Dr Christiane Kuhl, a radiologist at the University of Bonn and colleagues studied 7,319 women over five years for their study, which was also presented in June to a meeting of the American Society of Clinical Oncology.

MRI found DCIS in more than 90 percent of the 167 women with the condition, while mammograms only found 56 percent of DCIS cases.

"MRI could help improve the ability to diagnose DCIS, especially DCIS with high nuclear grade," Kuhl's team wrote.

Too soon to recommend
But Debbie Saslow, director of breast and gynaecologic cancer at the American Cancer Society, said it is far too soon to use MRI routinely for breast cancer screening.

"The American Cancer Society recommends that MRI screening be done annually in addition to mammography starting at age 30 for women at high risk," Saslow said.

"For the most part, these are women who have had either a genetic test or found a mutation (that puts them at high risk of developing breast cancer), there is a mutation in the family, or there is a strong enough family history that would lead you to think that the risk of having a mutation is pretty high," she added.

Women who already have had breast cancer have only a moderate risk of a recurrence and are not necessarily candidates for MRI, Saslow said. The reason is that MRI is expensive and has a high rate of false positives, meaning it detects lesions that are harmless.

"Sometimes doctors will think they see something. With MRI it is not clear-cut," Saslow said. "Some of those women are choosing to have mastectomies."

And having an MRI does not save women from undergoing the uncomfortable mammogram process, as MRI’s are always done alongside mammograms, Saslow noted. "Mammography still finds things that an MRI doesn't," she said. Breast cancer is diagnosed in 1.2 million men and women globally – (Maggie Fox, Reuters)

Read more:
Breast cancer survival in genes
Major clues to breast cancer


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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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