MR imaging is significantly better than mammography in detecting additional breast cancers in women who have already been diagnosed with the disease--an important finding that could ultimately affect the treatment of a significant fraction of new breast cancer patients, a new study shows.
The study (The Italian Trial for Breast MR in Multifocal/Multicentric Cancer, promoted by The Italian Society of Medical Radiology) included 90 women who had been diagnosed with breast cancer. Some of the women had cancer detected in both breasts. Each of the women had a mammogram and an MR examination to determine if there were additional cancers that had not been initially detected, said Francesco Sardanelli, MD, lead author of the study, chief of diagnostic imaging at the Istituto Policlinico San Donato and professor at the Postgraduation School of Radiagnostic at the University of Milan, Italy. Previous studies have shown that as many as 42% of women diagnosed with breast cancer in one breast have at least one other malignant lesion in that same breast, Dr. Sardanelli said. "We need to identify as many as possible malignant areas in the patients breast, so we and she can determine what is the best choice of treatment," he added.
Mammography detected 124 malignant lesions, while MR detected 152, Dr. Sardanelli said. All of the women had mastectomies. Their breasts were then examined by a pathologist. The pathologist found 188 malignancies, he said. While MR did not find all of the malignancies, it did find more than mammography, said Dr. Sardanelli. In addition, "the malignancies that were missed by mammography were significantly larger and more aggressive (70% were invasive cancers) overall than the malignant areas that were missed by MR," said Dr. Sardanelli. MR imaging was even more effective for women with dense breasts, noted Dr. Sardanelli.
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