Word: cancerous
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...Because MRI is particularly good at diagnosing small tumors - and picking up abnormalities that mammograms may miss in young women with dense breast tissue - which may cause undue anxiety. Evidence suggests that women who opt for MRIs tend to react to seeing their lesions, whether they are cancerous or not, by having their entire breast removed rather than just a portion of the tissue. "I just saw two patients who both had MRIs done at an outside institution, and both came in wanting mastectomies based on the MRI findings," says Dr. Anthony Lucci, a surgical oncologist at M.D. Anderson Cancer...
While there is no doubt that MRIs are more sensitive than mammograms, says Dr. Daniel Hayes, clinical director of breast oncology at the University of Michigan Comprehensive Cancer Center and a co-author of the commentary, it's not clear that the technique is more specific than mammography. Studies of each diagnostic screen have shown that compared to mammograms, MRIs can pick up additional cancer lesions 16% of the time. "But," says Hayes, "the question is whether they are biologically important...
...risk of recurrence in women treated for early-stage breast cancer ranges from 5% to 10% in the 10 years after diagnosis. Three decades of studies have shown that lumpectomy combined with radiation therapy yields the same survival and recurrence rates as mastectomy; while more cancer may remain in a breast following lumpectomy, these lesions are generally destroyed by the radiation, which gives the two procedures the same outcomes. Yet women receiving an MRI tend to choose the more invasive approach. (Read about the benefits of post-cancer weightlifting...
According to the studies that Hayes and his co-author, Dr. Nehmat Houssami, analyzed, such mastectomies are often unnecessary; earlier studies have shown that many of the small cancers that a lumpectomy may leave behind are in the same region as the surgery site, and therefore will most likely be destroyed by the radiation treatment that follows. "Radiation is very good," says Dr. Larry Norton, a breast-cancer specialist at Memorial Sloan Kettering Cancer Center in New York City. "We do know that if you don't irradiate a breast after surgery, you get local recurrence." (Read "The Year...
Aside from increasing the rate of radical surgery, the use of MRIs may also harm patients who already have a diagnosis. Patients may take several weeks to investigate the lesions, get biopsies and wait for pathology results, delaying the actual treatment of cancer...