MRI for Breast Cancer

Breast cancer is one of the leading causes of death by cancer in women. But it has been observed that death rate has declined since 1990. More women survive because of the availability of advanced medical imaging techniques that helps detecting cancer at an earlier stage when it can still be controlled or cured. Advanced therapies and treatments further improve the chances of survival in women. The medical imaging technique more commonly used for the detection of or diagnosis of this conditions screening with mammography. Usually this screening technique is used in order to detect any early evidence of underlying symptoms that would lead to cancerous growth.  

More tumors are detected during regular screening, but since many tumors develop in between tests, there was a need to come up with better screening techniques that can give evidence of tumor that may be cancerous. It became one of the important guidelines to look for asymptomatic cancer in the breast. For women at high risk, a different protocol was recommended by the American Cancer Society (ACS) with a revision in the screening recommendations. According to these guidelines it is advised that along with the annual mammography, women at high risk for developing cancer in the breast should also undergo MRI scanning. 

MRI is Magnetic resonance imaging that makes use of magnetic field instead of radiation that helps in the acquisition of an image of breast. Since MRI scanning technique provides high contrast in soft tissues, it helps in detecting malignancies easily. In 1990s, MRI scanning was first used to detect breast implants that have ruptured. Tumors in dense breast tissues can be detected with the use of intravenous contrast agents for example gadolinium along with MRI scanning. For mammograms that hinted the presence of malignancies, MRI with contrast helped in providing confirmatory diagnosis.

Since last few years the results obtained from clinical trials have suggested that MRI should be used in detecting tumors. However, it is still not known if MRI scanning can help in achieving the primary goal of detecting cancers at an early stage - that is decreasing fatality.

For MRI scanning in women to detect breast cancer, the patient will be asked to wear a front opening robe provided by the medical facility, as it is in case of any mammography testing. The patient should remove any metallic object worn by them like, belts, wrist watch, eye glasses, jewelry etc. A small catheter will be inserted in the patients arm to inject the contrast agent before the patient is being scanned. The patient then needs to lie down on the MRI table with their arms above their shoulder. The MRI table will now move into the scanner. The patient is advised to stay very still during the entire duration of scanning. This may take about 15 – 20 minutes.

Although ACS recommends MRI for women with breast cancer risk, it is still not recommended by the National Cancer Institute (NCI). To know if a woman belongs to the high risk category of, clinical researchers have come up with certain criteria’s. These criteria’s include, a positive test for mutations that provides information on genetic risk, survivors of Hodgkin’s disease (who may have 50% chances of developing cancer) and alternatively it can be found in the NCI risk calculator at the Breast Cancer Assessment Tool which provides access to tools that would help analyze if the patient falls under the high risk of developing breast cancer, in order to undergo MRI.

The risk for this condition changes with age and an equally important factor is the family history. Thus if a patient cannot decide if they fall under the ‘high risk’ or ‘average risk’ (the only 2 protocols for screening) the patient should consider taking an appointment with the physician.

 
Due to multiple clinical trials conducted now-a-days, researchers may come up with many new protocols that would act as a screening recommendation in order to detect and hopefully eliminate breast cancer. Until then mammogram is the best screening technique that can turn up early stage tumors that can be treated for women over 40 years of age.

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