Abbreviated MRI recommended for women at risk for breast cancer

Most women have heard that one in eight women will develop breast cancer during their lifetime, but few of them know that their individual risk may be greater than this one. Individual risk is based primarily on age, family history and, to a lesser extent, on factors such as smoking, weight and exposure to chemicals.

Age is the main risk factor for breast cancer. Breast cancer is more common in women over 60 and continues to progress with age. The problem is that even though breast cancer is more prevalent among mature women, it still occurs in younger women and tends to be much more aggressive in younger women than breast cancer patients with slower growth. last years. This means that you are much more likely to die of breast cancer when you contract it at a younger age. Although the risk of breast cancer is lower in young children, about 35 to 40% of all breast cancers are formed before the age of 60. Therefore, we can not just start screening women 60 and over. The rise of breast cancer begins around the age of 40 and the risk of breast lesions by irradiation is almost completely eliminated at the age of 40; therefore, we recommend starting the annual screening mammogram at age 40.

If you do not have a family history of breast cancer, you may be tempted to give up testing all together or at least postpone it to more advanced age. This is not a good idea. Only 25% of all breast cancers occur in women with a family history or genetic mutations leading to breast cancer at an earlier age. This means that 75% of all women who develop breast cancer have absolutely no family history or genetic risk of developing breast cancer. It's a scary fact that most women do not know.

The good news is that there has never been a better time to survive and thrive after a breast cancer diagnosis. Breast cancer is no longer the death sentence that he was. We diagnose breast cancer at an early stage and treat it with life-saving curative treatments. Breast cancer has become a retarder in life rather than a life-threatening event.

To maximize the benefits of these advances, however, we need your help. You must undergo breast cancer screening every year after age 40 to catch cancer at its earliest stage, before it spreads and becomes harder to treat and cure. The cure rates for early detection are close to 100%. The cure rates for advanced detection are 20% or less. Early detection is the key to maximizing your chances of survival.

Although annual screening mammograms have been the mainstay of early detection and it has been proven that it saves lives, there is another test that detects breast cancer even better than mammography, MRI of the breast. 3D mammography will detect approximately seven breast cancers per 1,000 screened women. MRI detects 14 breast cancers per 1,000 screened women. Thus, it detects twice as many cancers as mammography. So why not screen all women with an MRI instead of a mammogram? The answer is the cost and availability of MRI. Until now, breast MRI screening was too expensive for all women as a routine annual screening test.

To cope with this cost, the Midland Memorial Hospital will soon be offering a breast screening MRI for those who qualify at a very low cost. This study is much shorter than a standard diagnostic breast MRI, but requires an intravenous injection of gadolinium (MRI contrast agent). The American Cancer Society recommends MRI for all women whose risk for life is greater than 20% and for patients diagnosed with breast cancer before the age of 50. The Breast Center offers a free risk assessment for life called "Gail score". all women who receive screening mammograms at the center. This score will determine if you are qualified for abbreviated MRI breast screening. Currently, breast MRI screening is covered by insurance and Medicare for women at high risk of breast cancer, but not for those at medium risk. The abbreviated MRI breast screening may also benefit women with dense breasts; it can replace breast ultrasound in addition to mammography.

With a monthly breast exam, screening imaging studies such as mammography, ultrasound and MRI, which detect breast cancer before you can feel it, should be part of every woman's health strategy after 40 years. care of you, who will do it?

Dr. Jess Dalehite is a diagnostic radiologist at the Breast Center.