Study Questions Use of MRI to Evaluate Breast Cancer

A physician who orders an MRI scan on a woman recently diagnosed with breast cancer ultimately increases her chance for a mastectomy, according to a new study presented at the American Society of Clinical Oncology (ASCO) 2008 Breast Cancer Symposium, held Sept. 5-7.

The study indicates that MRI scans not only delay treatment up to three weeks but have a high rate of false positives as well. A false positive may mislead women into the decision to have a mastectomy when, perhaps, a lumpectomy would suffice. With no evidence to support that MRI scans benefit outcomes, the study questions whether they are necessary at all prior to treatment, and speculates why physicians are increasingly ordering them to evaluate breast cancer.

According to an earlier Government Accountability Office (GAO) report, Medicare imaging spending increased roughly 200 percent between 2000 and 2006. In response, Senate Finance Committee ranking member Chuck Grassley (R-Iowa) introduced the Medicare Imaging Disclosure Sunshine Act of 2008 (S3343) in July. If passed, the new law would require physicians to disclose their financial ties to imaging services ordered under Medicare when making self-referrals. While this legislation has yet to get by the Committee of Finance, imaging for diagnosis and treatment remains under close scrutiny by the Medicare Payment Advisory Commission (MedPAC).

This report is based in part on a Sept. 9 Fox Chase Canon Center press release.

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2 Responses to “Study Questions Use of MRI to Evaluate Breast Cancer”

  1. Lori Fiandra says:

    Being a breast cancer survivor I am obligated to comment on this finding. After 6 years of normal mammograms, and 3 months after a normal mammogram, I felt a large lump in my breast. To my amazement I had Stage II Breast Cancer which, based on the size of the tumor, was estimated to have been there a minimum of 3 years. I had a mastectomy and have never regreted my decision. After my mastectomy there was additional cancer found in the breast in another location and Paget’s disease in the nipple – if I did not have the mastectomy and only had a lumpectomy this would not have been discovered. I also realize that the knock on MRI’s is that it will increase the number of sensless biopsies……..I say bring on the biopsies and catch this disease much earlier. If MRI can do that then I do not understand why it is not a useful screening tool. I truly believe that it all comes down to the insurance companies not wanting to pay for preventive MRI screening.

    Thank you.

  2. Lynne Padilla says:

    Hurray for you Lori. Thank you for standing up for breast cancer diagnostic treatments. I lost my sister at the age of 35 to this horrible disease. It is possible that an MRI could have detected her cancer earlier, as it did not show up on mammogram or exam unitil it was too late. I’m with you – a biopsy is better than dying. Bring on the MRI’s.

    Good luck on staying cancer free.

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