Should you have a Breast MRI before surgery?

That’s a question that many people newly-diagnosed with breast cancer might be asking their surgeon.  Currently, there isn’t definitive data to show whether having a breast MRI before surgery changes a patient’s outcome, so it isn’t easy for your surgeon to give you a definite yes or no to that question.

The debate going on isn’t about whether MRI finds more cancer, but instead, whether it improves diagnostic accuracy and therefore outcomes (such as reducing the number of surgeries or cancer recurrances, and whether survival rates improve).

A study done at Yale University and presented at the Radiological Society of North America’s annual conference in 2011 showed that re-operation rates were dramatically reduced when breast MRI was used.  But that is just one study, and there are others out there that show no difference.

So, why do we do breast MRI?  At Canada Diagnostic, we offer breast MRI as a way for patients and their surgeons to get the clearest picture possible about the size, shape and location of their cancer.  A small percentage of women will have a tiny cancer in their other breast that wasn’t seen on mammography or ultrasound, and a number may have a tumour that is actually larger or more extensive than what was seen on their diagnostic imaging.  This information is helpful when planning surgery (lumpectomy and breast-conserving surgery) and can help reduce the need for a follow-up surgery.    For some patients, the peace of mind that comes from knowing the “full picture” is important.

The role of breast MRI in the management of breast cancer is probably going to start changing in the coming years.  As we learn more and more about the biology of the different types of breast cancer, researchers may begin to develop imaging sequences based on the particular type of tumour the patient has.

If you would like to learn more about breast MRI and whether it might be right for you, call us today at 604-709-8522 or drop us an email at info@canadadiagnostic.com.   And don’t forget to have your annual mammogram if you are a woman over 40 – its still the best first-line tool we have for finding cancer early.

Breast MRI helps predict chemo’s effectiveness

MRI that is used to determine how well breast cancer tumours are responding to chemotherapy may help shape patient care.  A new study shows how imaging can play a vital role in characterizing a tumor and monitoring treatment response.

A study done at the University of California (San Francisco) looked at the results of women who had chemotherapy prior to surgery.  They received Breast MRIs before their chemo started, after one round of chemo, after a second round of chemo and again prior to surgery.

Breast MRI proved to be better than clinical examination in accurately showing how well a tumour responded to chemotherapy and how much tumour was remaining.  Researchers found that the best predictive information about how a tumour is responding comes early in treatment–during the MRI done after the first treatment.  This means that doctors can get useful information early on in a patient’s chemotherapy to determine how well its working.  Treatment changes then can be made if necessary.

If you have received a diagnosis of breast cancer, or have had breast cancer in the past, talk to your doctor about having a Breast MRI. 

Breast MRI exams are available at Canada Diagnostic, analyzed by a radiologist with a sub-speciality in breast imaging.  Call us today for more information at 877-709-8522 or email us:  info@canadadiagnostic.com

Adding MRI or Ultrasound to Mammograms may help discover more cancers

Women with an increased risk of breast cancer AND dense breasts may benefit from adding ultrasounds or MRIs to their annual mammogram screenings.

Researchers from 21 institutions affiliated with the American College of Radiology Imaging Network (ACRIN) found that ultrasounds and MRIs found additional cancers not seen by mammography alone.  The study concluded that supplemental ultrasounds increased cancer detection by an average of 4.3 cancers per 1,000 women per year while MRI further increased cancer detection by an average of 14.7 cancers per 1,000 women per year.

Why doesn’t mammography find these cancers?  One of the lead researchers said that looking for a cancer in a woman with dense breasts via mammography is “like looking for a polar bear in a snowstorm”.  Dense breast tissue looks very white on mammography – and so does cancer.

So who exactly should get supplemental MRI and/or ultrasound?  Women who have dense breasts and more than one risk factor for breast cancer.  Risk factors include a having a known or suspected breast cancer gene mutation, prior radiation therapy to the chest area, prominent family history of breast cancer, prior atypical biopsy and extremely dense breasts.  Its best to review your history and risk factors with your doctor.

To learn more about whether a breast MRI or screening ultrasound is right for you, talk to your doctor or call us for more information any time at 604-709-8522.  Or visit us on the web.

Pre-Op Breast MRI reduces repeat surgery

A Study presented by Yale School of Medicine Professor Liane Philpotts,  shows that patients with newly diagnosed breast cancers have fewer repeat surgeries when they have an MRI first.   http://rsna2011.rsna.org/search/event_display.cfm?printmode=n&em_id=11005598

The results were most dramatic in patients who have dense breast tissue (dense tissue is more challenging to evaluate on mammogram and ultrasound). 

When a lumpectomy is performed, if there are any cancerous cells remaining around the excision area, a second surgery is required to remove more tissue to ensure “clear margins”.  Breast MRI has been shown to show the size and shape of a cancerous lesion better than mammography or ultrasound, thus helping the surgeons be more accurate in the removal of the tumour and reducing the need for a second surgery.

Pre-op breast MRIs also show the extent of the disease better than mammography or ultrasound, and is often able to detect additional cancers in the same breast or other breast.  This information is very important in helping the patient and her medical team decide the best course of treatment.

Breast MRI is a useful tool for cancer staging and is not a substitute for screening mammography.  Patients who are breast cancer gene carriers and therefore are at high risker risk for developing breast cancer, may be candidates for MRI screening, but should also be screened annually with mammography.

For more information on Breast MRI at Canada Diagnostic Centres, click here, or call us at 1-877-709-8522.