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MRI Significantly Better than Mammography for Detecting Number and Size of Tumors in Breast Cancer, First International Study Shows
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Article Date: 08 Jun 2004 - 4:00 PST
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(New Orleans, LA)
- Researchers from the Abramson Cancer Center of the University of Pennsylvania
today presented the first comprehensive study results which show that magnetic
resonance imaging (MRI) is significantly better than traditional mammography for
detecting the presence and extent of disease in patients with a diagnosis of
breast cancer.
The research has significant implications for women
considering surgical options - other than a full mastectomy - to remove their
breast cancer, such as a lumpectomy. Indeed, an MRI is recommended for all women
considering surgical options, in order to detect the full extent of the breast
cancer prior to surgery, yet preserve as much healthy breast tissue as possible.
Abramson researchers led the first international, multi-site group of
researchers to study the subject - the International Breast MRI Consortium
(IBMC) - and presented their results at the 40th Annual Meeting of the American
Society for Clinical Oncology in New Orleans.
"There has never really
been a gold standard for detecting how many tumors or how widespread is a
women's breast cancer," said study principal investigator and professor Mitchell
Schnall, MD, PhD, a radiologist at the Cancer Center and chief of the MRI
section at the University of Pennsylvania Medical Center.
"These study
results are very conclusive that breast MRI works better for detecting breast
cancer, and physicians - when evaluating surgical options for breast
conservation - should be using MRI over traditional mammography with physical
exam for determining how widespread the tumors are and how much tissue really
needs to be removed."
The study - at 17 different sites throughout the
US, Canada and Germany - examined more than 1000 women, most of whom were over
the age of 40, for a period of three years. All of the women had suspicious
lesions on their mammograms, which required further investigation to see if
cancer was present. Each participant had both follow-up mammograms and MRIs.
Cancer was confirmed by a biopsy, surgical removal and microscopic
examination of the tissue. Of the 428 women who had breast cancer, MRI detected
additional cancerous lesions in 56 women, while mammograms detected additional
lesions in only 17. In statistical terms, MRI was more than 2 times as effective
than mammography in detecting multiple tumors.
Prior to this
international study, only single-site data was available and, due to small
populations (less than 100 women) and the increased potential for
single-population bias, the results could not be considered conclusive.
"The impact for patient care is significant," said Schnall. "Because MRI
is so sensitive at detecting as much of the breast cancer as possible, we can
hopefully improve the effectiveness of lumpectomy by reducing the rate of
recurrence of breast cancer."
"Additionally, if we capture more of the
cancer at the time of detection, there will be less of a need for radiation
therapy after surgery - allowing for fewer side effects from
treatment."
Current statistics for the recurrence of breast cancer -
after breast conservation therapy, such as lumpectomy - are three to 19 percent
after ten years. Preventing recurrence is strongly linked to removing all
tumors, through full surgical margins (the amount of surrounding tissue that is
removed along with the tumor) and accurate detection of cancerous
tissue.
MRI is a non-invasive procedure that uses powerful magnets and
radio waves to construct pictures of the body. Unlike conventional X-rays, MRI
imaging uses the magnetic properties of atoms to differentiate organs, and
contrast benign and malignant tissue. Imaging planes (or "slices") from any part
of the body can be projected, stored in a computer, or printed on film. MRI can
easily be performed through clothing and bones.
Funding for the study
was provided through a research grant in 1997 from the National Cancer Institute
that totaled nearly $5 million. At the time, it was the largest grant ever
awarded for breast MRI research.
The American Cancer Society estimates
that in 2004 over 200,000 American women (11,000 in Pennsylvania alone) will be
diagnosed with breast cancer and 40,000 will die from the disease.
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