2008 - Communication Across the Curriculum (CAC)

R a d i o l o g i c T e c h n o l o g y
Services regularly reconsider their screening guidelines. “In
the last 30 years, the American Cancer Society (ACS) has
revised its breast cancer screening recommendations six
times” (Schatz, 2007). Saliva tests, as well as the advent of
magnetic resonance imaging, may imply an uncertain future
for mammography as the primary screening tool for breast
cancer, but will these new methods replace the tradition of
annual mammograms for women
Magnetic resonance imaging is increasingly used for
the detection and evaluation of breast cancer (Bremner &
Recabaren, 2007). Accepted indications for the use of breast
MRI include:
1) axillary node metastases from suspected occult primary
breast cancer, 2) monitoring response to neoadjuvant
hormonal therapy or chemotherapy, 3) determining ipsilateral
tumor extent or presence of contralateral disease in patients
with proven invasive lobular breast cancer, 4) breast cancer
screening for patients at very high risk for developing breast
cancer, specifically those with suspected or proven mutations
of BRCA one/two, and 5) additional evaluation of suspicious
clinical findings or imaging results that remain inconclusive
after complete mammographic and sonographic evaluations
combined with physical exam (Bremner & Recabaren, 2007).
MRI’s magnetic fields create excellent image contrast of
the breast’s soft tissues when used in conjunction with an
intravenous contrast agent called gadolinium (Schatz, 2007).
Furthermore, “[T]he favorable sensitivity of MRI may help
identify occult areas of breast cancer that are more extensive
than appreciated on conventional mammography” (Bremner
& Recabaren, 2007). Studies have shown that for patients
already diagnosed with cancer “breast MRI more accurately
defined the extent of tumor than did conventional imaging”
(Bremner & Recabaren, 2007). Although several studies have
demonstrated MRI’s superior ability to detect cancer, it does
have disadvantages.
One reason none of the nationally recognized advisory
boards recommend breast MRI for women at average risk of
developing breast cancer is the prevalence of false positives.
“Because MRI is so good at picking up any abnormal tissue,
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