Mammography is the most commonly used screening test for early detection of breast cancer but recently there is a new trend preferring the use of breast MRI for breast cancer screening specially for women at high risk for developing tumors.
Advantages of breast MRI over mammography.
Breast MRI studies offer two main advantages over mammography. MRI doesn't involve exposure to radiation, so it is safer than mammography, and it is more sensitive; it has a higher ability to detect and pick up breast cancers than mammogram. Up till now, not all physicians are enthusiastic about using breast MRI as a screening test for breast cancer. Previous studies of MRI as a screening test for breast cancer revealed that MRI is very sensitive for picking up breast tumors, it can even detect tumors that missed by mammography. The problem lies with its specificity. Breast MRI is not specific for breast cancer in particular but for any abnormal change which might not be a true cancer. This can lead to unnecessary biopsies, which is a source of anxiety for most women.
A new research studying the sensitivity and specificity of MRI for breast cancer screening argues that the specificity of breast MRI may be higher than what scientists had previously thought. In a recent study published in the Journal of Clinical Oncology, researchers found the sensitivity of breast MRI to be 93% with a specificity of 98%. This means that a breast MRI misses only 7 % of breast cancer cases and in only 2% of cases does the abnormality turn out to be something other than a breast cancer, thus breast MRI is much more sensitive than and just as specific as mammography. According to this study alone, using breast MRI to screen for breast cancer would seem to be a more accurate and reliable test than mammography.
Despite its higher ability to pick up breast tumors that mammograms miss, using breast MRI to screen for breast cancer also has its drawbacks. The biggest problem is standardization. Breast MRI is not widely used at this point, and there is a lot of problems with the quality of the films and the way they are interpreted. Breast MRI is also more time-consuming and costly than mammograms. So far, most doctors recommend MRI only for women at high risk for breast cancer and in conjunction with mammography. Breast MRI is very useful to women at high risk for breast cancer because MRI could pick up tumors at an earlier stage than mammography. Some women at high risk refuse to carry out a breast MRI study because they fear being in a closed space. Unfortunately, a breast MRI can not be performed using an open system at this point. Hopefully, this will change in the future. A breast MRI should be performed at a center that can do MRI-guided biopsies, otherwise, the procedure could have to be repeated somewhere else if it shows an abnormality. Currently, breast MRI is only recommended for women at high risk, but this test offers a great hope for women, specially if future studies confirm its high specificity.