MRI scans 'shouldn't guide treatment decisions for early-stage breast cancer patients'

In collaboration with Adfero

Magnetic resonance imaging (MRI) may not be the most appropriate way to assess women with early-stage breast cancer, a surgeon at University College Dublin has said.

MRI is a sensitive imaging technique that can be used to provide detailed images of the inside of the breast. It is not routinely used in the UK for women with early-stage breast cancer, however.

The technique can be valuable for monitoring advanced breast cancer and assessing the effect of chemotherapy, according to Malcolm Kell, consultant surgeon and senior lecturer at University College Dublin's Eccles Breast Screening Unit.

Writing in the British Medical Journal, Mr Kell suggests that MRI scans may actually do more harm than good in patients with early-stage breast cancer, as they could lead some women to have surgery that they do not need.

This is because the technique sometimes produces 'false positive' results and may pick up harmless growths that do not need to be removed.

The surgeon cited a UK study involving women with breast cancer who were being considered for breast-conserving treatment.

The study found no difference in re-operation rates between women who had MRI scans and women who did not.

However, women who had MRI scans were six per cent more likely to have a mastectomy than those who did not have a scan.

Mr Kell wrote: "Its routine use in the management of patients with early-stage breast cancer may be unwarranted - we have no evidence to support a clear benefit in this setting."

He concluded: "There is no compelling evidence that this technique should be routinely used in newly diagnosed breast cancer."

Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "This study doesn't tell us anything new - we know that MRI scans are a very sensitive way of picking up breast cancer but this can lead to more overdiagnoses and overtreatment. In the UK, doctors routinely use x-ray mammography to help decide how best to treat women with early-stage breast cancer, although MRI may be used to monitor women at high risk of inherited breast cancer.

"The mammograms women get through the NHS screening programme are x-rays, rather than MRI scans, which are effective at picking up cancer at an early stage when the disease is often easier to treat."

References

  • Kell, M. (2010). Magnetic resonance mammography BMJ, 341 (oct20 4) DOI: 10.1136/bmj.c5513