Author Affiliation: Department of Surgical
Oncology, Fox Chase Cancer Center, Philadelphia, Pa.
The use of magnetic resonance imaging (MRI) of the breast is being examined
in 2 distinct settings: as a screening test in women at high risk for breast
cancer development such as those with mutations of the BRCA1 and BRCA2 genes; and as an adjunct to
mammography for the selection of local therapy in women with known or suspected
breast cancer. The rationale for these 2 approaches is quite different. In
women with predisposition mutations, breast cancer often occurs at an early
age when dense breast tissue decreases the sensitivity of mammographic screening1,2 and interval cancers are common2 due to the histological features and rapid growth
rates of cancerous tumors occurring in mutation carriers.3-5 These
observations provide a strong biological rationale for examining alternative
screening methods, particularly those not influenced by breast density. Two
recent prospective trials6,7 suggest
that MRI screening in this high-risk population is a promising approach.
Morrow M. Magnetic Resonance Imaging in Breast Cancer: One Step Forward, Two Steps Back? JAMA. 2004;292(22):2779–2780. doi:10.1001/jama.292.22.2779
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