MRI and treatment decisions

MRI MachineIllustration ? A.d.a.m. Eva was diagnosed with a tumor invasive breast cancer of 3 cm. As part of its diagnostic workup, had two breast MRIs, made to help the surgeon to see if any tumor cells from the primary tumor had scattered (had) so that he could be sure of getting clean surgical margins (did). Her MRI created a three-dimensional image of the tumor, revealing that he was not 3 cm, as her mammogram revealed, but was, indeed, 5 cm, who changed his plans of treatment-– and his life.

In order to help you understand more about using MRIs and treatment decisions, I looked at what the experts say in UpToDate--a trusted electronic reference that is used by many Oncologists who treat patients with breast cancer.

It may or may not be necessary a breast MRI. But you must know the size, extent and location of your cancer. Start by reading this excerpt to see why a breast MRI may be important to you.

Diagnosis of cancer: a discussion of breast MRI by UpToDate

"magnetic resonance imaging (MRI) uses a powerful magnet to create a detailed picture of a body part. Does not use x-rays or radiation. Breast MRI may be recommended to assist in the diagnosis of breast cancer in selected situations. MRI is not recommended to detect breast cancer in women, because it is not as good as a mammogram for certain conditions, such as breast ductal carcinoma in situ (a kind of early breast cancer or non-invasive).

The role of breast MRI in the diagnosis and management of breast cancer is evolving, and there is disagreement about what women should undergo breast MRI in addition to mammography.

What is a Breast MRI?
Magnetic resonance imaging (MRI) is a non-invasive imaging technique that does not use no compression, x-rays or radiation. An MRI creates a detailed picture of the internal architecture of your breast tissue. Most of the MRI machines produce a digital image as a radiologist may examine on a computer or print for Study. This image can be done with or without the use of contrast agent.

Why Breast MRIs are used as part of a diagnostic Workup?
You've already had a mammogram and perhaps an ultrasound and biopsy. A breast MRI could happen even for some patients, to get more information on your cancer, or to see if tumors respond to treatment. Mammograms are far less expensive than those MRIs and are good at detecting HIGH-GRADE DCIS and calcifications. Breast MRI can image both breasts simultaneously and also works well with dense breast tissue. Is good at finding invasive cancer, breast imaging around and catch the eventual spread of cancer beyond the primary tumor. A breast MRI is also effective in finding unsuspected author about breast cancer in the other, which would allow early treatment of cancer both sites at once. For women at high risk of breast cancer, an MRI would be a good way to screen completely breasts and armpits.

Who might need a breast MRI?
Mammography is still the primary method of screening for breast cancer and breast MRI is used mainly as a supplement for a mammogram. For young women with BRCA mutated, MRI can be used as screening for breast cancer, see inside dense breast tissue which otherwise might hide masses. In breast MRI diagnostic use, can be used in these circumstances: If a woman has swollen lymph node armpit, but does not amount to breast mass on a mammogram, and an MRI can be used to carefully examine your breasts to see if there is a small tumor cells and may have shed to axillary nodes. For a newly diagnosed women with dense breasts, mammography may not give enough guidance to the surgeon. So an MRI can be done to get more information about architecture. When the biopsy results indicate a tumor larger than a mammogram reveals, an MRI can help delineate the size and location of the tumor. This will affect your decision as regards the amount of tissue should be removed –-Lumpectomy or mastectomy. If it seems that there is more of a tumor in the breast itself, an MRI can help the image size and spatial relationship of more tumors and help in planning surgery the right to remove such injuries.Message to bring home
Before making a decision on what to have surgery, you and your surgeon need as much accurate information as possible about your cancer. If you have a clear diagnosis of DCIS and mammography gives a good picture of your tumor, then your surgeon will probably has all the information you need to remove the tumor. But if the mammogram doesn't provide enough detail, or if your surgeon or radiologist has more concerns about the size and location of the cancer, and can benefit from a breast MRI.

As regards the Eva, you chose to participate in a clinical trial and has taken a new drug that has greatly reduced its tumor, before having breast surgery. He also had MRI guided biopsy, which revealed satellite lesions. Fortunately, these other injuries disappeared during chemotherapy. Her MRI was a key part of her treatment decisions.

Want to know more? For more in-depth medical information, current and unbiased on breast cancer, including recommendations of expert physician, see topic of UpToDate, "Breast Cancer Diagnosis: A discussion of breast MRI,".

Source:

Diane MF Savarese, Leah K Moynihan, "diagnosis of breast cancer: a discussion of breast MRI," UpToDate. Access: February 2009.

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