Thursday, March 29, 2007
Breast MRI advised
By: Jeffrey Kurz, Staff

MERIDEN - American Cancer Society guidelines now recommend annual magnetic resonance imaging scans for women who have breast cancer or are at high risk for the disease, starting at age 30.

A report in the New England Journal of Medicine, published Wednesday, found MRI scans can detect cancer in the other breast at the time of a breast cancer diagnosis more effectively than mammography and other examinations.
The advice adds about 1.4 million women to the number of those who will need annual MRI for breast cancer detection. The cancer society recommends scans and mammograms each year for the high-risk group.

More effective detection of what's called contralateral breast cancer can have a great influence on how a patient is treated, said Dr. Gary Dee, a radiologist with MidState Medical Center.

The sensitivity of MRI is an advantage for those with cancer or at high risk, but because it can yield false positive results it is not recommended as a routine screening for women with an average risk.

A corresponding editorial in the New England Journal of Medicine notes that while the availability of breast MRI is increasing, there is concern about the -- wide-ranging quality of the examinations. Imaging centers that provide scans without performing biopsies could lead women to have to repeat the examining process.

MidState has offered breast MRI for the past five years, adding computer-aided detection about four years ago.
The new recommendations validate the hospital's investment in the technology and training, Dee said.

"You have to know what you're doing," he said. "You have to have a full service."

"What we're happy with is that we're one of the small hospitals that pioneered this," Dee said.

MidState performs about 10 to 15 breast MRI scans a week and has the capacity to double that, said Dee.

"Not only are we ready, but we're already doing it," said Dr. Linda S. Durham, a MidState radiologist.

"We have a full range of biopsy options for MRI," she said.
MidState provides MRI breast scans at the hospital on Lewis Avenue and at Wallingford Diagnostic Imaging, on Barnes Road. The Wallingford machine is being outfitted to accommodate larger patients.

Ranging from $1,000 to $2,000, MRI scans are more expensive than mammograms. Insurance coverage could increase based on the new recommendations. "You have to fight for it quite a bit," said Dee.

Those at high risk for breast cancer include women with a strong family history and those with cancer-producing genetic mutations, BRCA1 or BRCA2. Others at high risk may include those who have been treated with radiation therapy for Hodgkin lymphoma.

The National Cancer Institute provides a risk assessment tool online, at www.cancer.gov.

About 180,000 new cases of breast cancer are estimated for women in the U.S. this year (and just more than 2,000 new cases for men), according to the National Cancer Institute. An estimated 40,460 women, and 450 men, are expected to die this year from the disease.