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Thought for the Day: MRI as a gold standard

Just recently, European researchers announced that MRI scans offer a new way to detect breast cancer in its earliest form. They can even prevent cancer among high-risk women.

Better than standard mammograms, MRI can detect a nonmalignant tumor called ductal carcinoma in-situ, or DCIS. Once found, the lesion can be surgically removed before it becomes cancerous.

Think about this: It is believed that almost all breast cancer starts out as DCIS. And this: if MRI were the gold standard breast cancer screening tool, we might be able to prevent a lot more breast cancer cases than we do now. It seems researchers agree.

"MRI should thus no longer be regarded as an adjunct to mammography but as a distinct method to detect breast cancer at its earliest stage," they say.

The American Cancer Society (ACS) is not ready to put their stamp of recommendation on MRI just yet. It's far too soon to use MRI routinely for breast cancer screening, says Debbie Saslow, the ACS director of breast and gynecologic cancer.

"The American Cancer Society recommends that MRI screening be done annually in addition to mammography starting at age 30 for women at high risk," Saslow said. "For the most part, these are women who have had either a genetic test or found a mutation (that puts them at high risk of developing breast cancer), there is a mutation in the family, or there is a strong enough family history that would lead you to think that the risk of having a mutation is pretty high."

Women who already have had breast cancer have only a moderate risk of a recurrence and are not even candidates for MRI, according to Saslow.

MRI is just too expensive right now -- the scan can cost $1,000 to $5,000 -- and has a high rate of false positives. Apparently, mammography still finds things MRI can't. So not yet can we rely solely on MRI. Wouldn't it be nice, though, if we could use them both -- for all women -- so we could knock out breast cancer before it becomes a real threat? I think so.

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