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Study Finds MRIs Delay Breast Cancer Treatment

Posted on: Sunday, 7 September 2008, 13:20 CDT

New research from Fox Chase Cancer in Philadelphia finds that women with newly diagnosed breast cancer who receive an MRI scan are far more likely to get a mastectomy, and wait three weeks longer before their surgery, than women who receive only a mammogram.

"MRI may not be as good as we think it is," said Dr. Richard Bleicher of the Fox Chase Cancer Center in Philadelphia.  

Bleicher presented his findings in Washington at the American Society of Clinical Oncology's Breast Cancer Symposium.

"Those who received an MRI had a three-week delay in the start of their treatment," he said in a statement.

"In addition to the treatment delay, we're concerned that the well-documented false-positive rate with MRIs may be leading -- or misleading -- women into choosing mastectomies."

Many women with newly diagnosed breast cancer, including younger women, are opting for MRI exams in addition their mammograms, he said.   The researchers wanted to determine what, if any, impact the scan had on a woman's treatment.

Bleicher and his team analyzed records of 577 breast cancer patients who had been evaluated by a pathologist, radiologist and a surgical, radiation and medical oncologist.   Of these, 130 received an MRI prior to having surgery to remove their tumors, and 27.7 percent of these had a mastectomy.   In the non-MRI group, only 19.5 percent had a mastectomy.

After adjusting for factors such as tumor size, the researchers said women who had received an MRI were 80 percent more likely to get a mastectomy.

The reasons why these women had mastectomies rather than lumpectomies is not yet clear, but may be related to the sensitivity of MRIs, which are known to have a high number of false-positive findings, Bleicher added.

"Rather than having a biopsy to see if those findings are real, women and their doctors may choose mastectomy out of an abundance of caution," he said.

The research supports a previous study conducted earlier this year that also found MRIs increase the odds a woman would have a mastectomy.

Bleicher and his research team reviewed the time from initial diagnosis to cancer treatment, and found that the women who received MRIs waited on average 22.4 days longer to have their surgeries.

"I can't tell you that a three-week delay will influence her survival, but I can tell you a three-week delay will increase the anxiety on her part," Bleicher told Reuters.

Breast cancer is diagnosed in 1.2 million people worldwide, killing 500,000, every year.

Bleicher and his team also examined whether MRI exams, which cost about 10 times more than mammograms, were better at helping doctors predict which women could have lumpectomies, a breast-sparing surgery in which only the tumor is removed.  Interestingly, they found that MRI was no better than traditional mammograms in this regard.

"We were very, very surprised because people tout MRI scans as being able to see the tumor better. Despite that, we are not able to choose the patients any better with it," he said.

To date, there is little evidence to show that MRIs help save lives, Bleicher said.

"MRIs are valuable and should be done in certain women at high risk, but they are not appropriate in routine evaluation of breast cancer.”

Source: redOrbit staff and wire reports

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