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Study: MRI Doesn’t Help Much In Breast Cancer

November 21, 2011
Written by: , Filed in: Breast Imaging
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The Lancet kicks off a series of articles on breast cancer with a study that questions the usefulness of MRI in helping doctors decide on treatment options for breast cancer.

Researchers from Memorial Sloan-Kettering Cancer Center in New York examined peer-reviewed articles published over the past decade for the study, published last week.

They concluded that MRI is a valuable screening tool for women with a genetically high risk of breast cancer and that it can accurately detect tumors that mammography and ultrasound miss. However, they said research is lacking as to whether that improved detection has an impact on survival.

That pretty much encapsulates the theme of the article: things that you’d think would be true turn out either to have limited or no support from available evidence or not to have been studied much—if at all.

For example, physicians often use MRI to learn more about a patient’s breast cancer before breast-conserving surgery. But, the article said there is no evidence that the increased sensitivity of MRI over other types of imaging for presurgical examination results in better surgical treatment or prognosis.

The study said it couldn’t determine the impact of MRI on longer-term outcomes because of the limited number and frequently poor quality of clinical trials.

It did say that MRI is more reliable than traditional techniques, such as physical examination, mammography, and ultrasound, for evaluating the extent of residual disease after preoperative chemotherapy. However, again, the researchers said it is unclear whether that improves the selection of suitable patients for breast-conserving therapy.

The study did say that MRI is good at detecting “very early changes in intracellular metabolism” that seem to be predictive of response to treatment. So MRI might signal when chemotherapy won’t help a particular patient, thus saving the toxicity and expense of the treatment.

That’s hardly much of a role for such a powerhouse technology.

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