A new study shows that MRIs may be the best screening tool to detect breast cancers in women at a high risk of the disease. Health expert Dr. Marla Shapiro provides more details.
- A new study shows that using MRI as a screening tool can help detect tumours missed by mammography and ultrasound in women at high-risk for breast cancer.
- The study appears in the August issue of the journal Radiolog
- The conclusion is that women at a high risk for breast cancer can benefit from screening MRI
- The study's lead author says MRI is the best tool currently available for detecting cancer.
- In this study - researchers estimated that screening with MRI will allow for the detection of 23 more cancers per 1,000 high risk women screened.
- It went on to say there was no evidence to support using MRI to screen average risk women.
- Genetic predisposition accounts for 5-10 per cent of all breast cancer. Women at a genetic high risk need to begin screening earlier, as they often develop cancer at an earlier age.
- Women below 50 are more likely to have dense breast tissue, which can limit the effectiveness of mammography as a screening tool.
Canadian Guidelines
- Cancer Care Ontario recommends using MRI in addition to mammography for some women with a high risk of breast cancer
- Cancer Care Ontario also recommends starting to screen women at a high risk for breast cancer at age 30
- Canadian recommendations are for mammography to start at age 40 for all women with no symptoms
- Women aged 40-49 years old should have annual screening
- Women aged 50-69 years old should have mammography screening at one to two year intervals if they are in good health.
- Women over the age of 70 should have screening mammography at one to two year intervals if they are in good health.
- Women who have symptoms, any new or unusual changes in their breasts, should be checked by their family doctor, and have a mammogram arranged.
- Ultrasound is not recommended across Canada as a screening tool except in specific circumstances
American Data
- The American Cancer Society is recommending women with a high risk of breast cancer should be screened with MRI in addition to yearly mammogram starting at age 30.
- For women with average risk, American recommendations are for women to undergo a clinical breast exam (in their doctors office) every 3 years from 20-39 years of age. This test should be conducted annually after the age of 40.
- American recommendations say that annual mammograms should start at aged 40 and should continue as long as a woman is in good health and would be a candidate for breast cancer treatment.
- In 2003, American guidelines said there was a growing body of evidence to show that women at an increased risk for breast cancer might benefit from earlier screening, and other screening methods such as ultrasound or MRI.
- Having one first-degree relative (a mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having two first-degree relatives with breast cancer increases her risk by five times.
- Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer.
- Altogether, about 20 per cent to 30 per cent of women with breast cancer have a family member with this disease.
