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December 8, 2004

Magnetic Resonance Imaging in Breast Cancer: One Step Forward, Two Steps Back?

Author Affiliations

Author Affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pa.

JAMA. 2004;292(22):2779-2780. doi:10.1001/jama.292.22.2779

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.