Around 90% of all breast cancers can be definitively diagnosed using MRI. In comparison, the combined methods of mammography and ultrasound yielded a detection rate of just 37.5%. This is the key finding of a study published in the Journal of Clinical Oncology. The study was carried out at the department of radiology and nuclear medicine at the Medical University of Vienna in cooperation with the department of gynaecology and obstetrics and the Clinical Institute of Pathology.
“In cases where there is even the slightest doubt, and especially in women at increased risk, the obvious choice is MRI. Our study clearly shows the superiority of magnetic resonance imaging over mammography and breast ultrasound examinations,” says Thomas Helbich, MD, who led the study with Christopher Riedl, MD. “The superiority of MRI is also completely independent of the patient’s age, gene mutation status, and breast density.”
In 559 women at increased risk, a total of 1,365 screening examinations were carried out and 90% of all breast cancers were clearly detected by MRI. The combination of MRI and mammography increased the detection rate by just 5%. None of the cancers were detected by ultrasound alone. The results were similar for noninvasive cancers and for benign breast lesions.
“An MRI scan carried out once a year is therefore the only alternative for high-risk patients who have a strong family history of breast cancer to the surgical removal of the breast and ovaries,” Helbich says. “This is by no means overdiagnosis, but rather a necessity. Around 13,000 women in Austria are still at increased risk of breast cancer.”
The results of the study should encourage the increased use of MRI for breast screening too, according to Helbich, who says: “In light of these results, it is our duty to make women more aware of the fact that the use of mammography and ultrasound cannot detect all types of cancer. MRI really is the method to be recommended.”
Currently, Austria has 18 MRI scanners per million inhabitants, putting the country above the European Union average (10 scanners/million inhabitants). However, if MRI is to be used more frequently, Italian or Greek ratios would be better; in these countries, there are 24 and 23 MRI scanners per million inhabitants, respectively.
— SOURCE: Medical University of Vienna