Might MRI save lives in women at high risk for breast Ca?

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In women who carry BRCA1 or BRCA2 mutations, MRI is more sensitive for detecting breast cancers than mammography, ultrasound, or clinical breast exam (CBE) alone, but whether this translates into reduced mortality is still unknown. This is according to the results of a surveillance study involving 236 Canadian women between the ages of 25 and 65.

In women who carry BRCA1 or BRCA2 mutations, MRI is more sensitive for detecting breast cancers than mammography, ultrasound, or clinical breast exam (CBE) alone, but whether this translates into reduced mortality is still unknown. This is according to the results of a surveillance study involving 236 Canadian women between the ages of 25 and 65.

A diagnostic method with increased sensitivity is especially critical for carriers of BRCA1 and BRCA2 mutations, who, despite annual mammograms and biennial CBEs, have many tumors detected at an advanced stage.

Of 22 cancers detected in the study, MRI detected 17 with seven of these detected by MRI alone, mammography detected eight, U/S detected seven, and CBE detected two. Sensitivity was 95% for all four modalities combined versus 45% for mammography and CBE.

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Henri M. Rosenberg, MD
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