Word: mris
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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...
...appearing in CA: A Cancer Journal for Clinicians, a publication of the American Cancer Society. The authors looked at studies pitting preoperative use of MRI, which relies on magnetic waves, against mammograms and similar tests that use radiation to take pictures of breast tissue. Researchers found that women choosing MRIs often ended up with more aggressive surgery - much of which wasn't necessary - than women who did not use the scans. What's more, employing the newer and more sensitive MRI technology did not improve a woman's chance of surviving cancer or her chances of avoiding a recurrence...
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...
...just take one example, and that is testing. It turns out that we pay 10 times what Japan pays, for example, for CAT scans and MRIs. Well, why is that? And it turns out, by the way, that we are having those tests five, six, eight times as often as folks in other countries who have just as good outcomes...
...often just as effective as costlier brand-name alternatives; that stents can work miracles when inserted quickly after heart attacks but don't seem to help much as preventive measures; that the areas with the most hospital beds, imaging machines and specialists spend the most on excess hospital stays, MRIs and specialty care. But the big money in medical research goes to testing new drugs and cutting-edge technologies, not to comparing existing treatments. Drug companies often just have to prove that their products are better than placebos to get FDA approval; new devices merely have to be similar...