||Research conducted at 25 institutions
across the country, including the Abramson Cancer Center
of the University of Pennsylvania, found the addition
of an MRI scan led to the detection of more than 90 percent of
cancers in the opposite breast missed by mammography and clinical
breast exam, increasing the number of cancers detected.
||Researchers are also optimistic that MRI
may lead to long term savings to patients and to the health care
system. The fact that MRI can detect most cancers in both breasts
prior to therapy may result in fewer rounds of chemotherapy and
fewer breast surgeries.
||The study was published in the March 29th, 2007 issue of the New
England Journal of Medicine
One in every 10 women newly diagnosed with cancer in one breast will also develop the disease in the opposite breast. These opposite – or
contralateral – breast cancers often take years to diagnose,
which can increase patient anxiety, lower the chance of successful
treatment, and lead to additional procedures.
conducted by the American
College of Radiology Imaging Network (ACRIN) study published
in the March 29th, 2007 issue of the New
England Journal of Medicine helps establish magnetic
resonance imaging (MRI) as a key component
of the diagnostic workup for women at the time of initial breast cancer diagnosis. The
research, conducted at 25 institutions across the country, including
Cancer Center of the University of Pennsylvania, found
the addition of an MRI scan led to the detection of more than
90 percent of cancers in the opposite breast missed by mammography and clinical breast exam, increasing the number of cancers detected.
think MRI is a very good option,” said Mitch
Schnall, MD, PhD, Matthew
J. Wilson Professor of Radiology and
senior author of the study. “It
can provide peace of mind for women when they’re diagnosed.
This study clearly shows that one in 30 women who think they have
cancer in one breast after a traditional evaluation with mammography
and clinical exam, actually have bilateral breast cancer that can
be detected by MRI. Knowing this at the time of diagnosis of the
first cancer has a significant impact on the approach to treatment.”
Supported by the National
Cancer Institute (NCI), the ACRIN trial
recruited 1,007 women across 25 sites, including Penn, who had
a recent diagnosis in one breast and found that the added benefit
of MRI was consistent – regardless of cancer type, age, and
breast density. Also, the diversity of medical facilities
participating in the trial that recruited patients – from
academic institutions, community hospitals, and imaging centers – suggests
that the results can be generalized to other practices.
In this study the MRI scan detected a variety of cancer types. In
general, those cancers were at an earlier stage than cancers found
in other types of exams, which is important because breast cancers
detected at an earlier stage are often more treatable.
Researchers expect that if a MRI of the opposite breast is negative,
women diagnosed with cancer in only one breast can more confidently
opt against having a double mastectomy. “Although no
imaging tool is perfect, if the MRI is negative, the chance of
cancer in that breast is extremely low. A potential outcome
that we would be delighted to see is fewer unnecessary bilateral
mastectomies and fewer recurrences years after the initial cancer
diagnosis," said Constance
Lehman, MD, PhD, principal investigator
of the ACRIN breast MRI trial, and Director of Breast Imaging at
the University of Washington and Seattle
Cancer Care Alliance. The
ACRIN trial also noted fewer “false positives,” or
initial findings that later proved not to be cancer, than previous,
smaller breast MRI studies had documented.
According to the NCI, in the United States breast cancer is the
most commonly newly diagnosed non-skin
cancer in women, and the
second leading cause of cancer-related death in women. In the United
States in 2007, an estimated 178,480 women will be diagnosed with
breast cancer, and an estimated 40,460 women will die of the disease.
Researchers are also optimistic that MRI may lead to long term
savings to patients and to the health care system. The fact that
MRI can detect most cancers in both breasts prior to therapy may
result in fewer rounds of chemotherapy and
fewer breast surgeries. According to Schnall, “This study
certainly points to future trials need for another, multi-center
study that clearly demonstrates the ability of MRI to detect cancer
not seen by mammography. Hopefully, this will lead to recommendations
from the American
Cancer Society for all women who fall into high
risk categories for breast cancer to add MRI screenings to the
arsenal in the fight against cancer."
PENN Medicine is a $2.9 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn's School of Medicine is ranked #2 in the nation for receipt
of NIH research funds; and ranked #3 in the nation in U.S. News
& World Report's most recent ranking of top research-oriented
medical schools. Supporting 1,400 fulltime faculty and 700 students,
the School of Medicine is recognized worldwide for its superior
education and training of the next generation of physician-scientists
and leaders of academic medicine.
The University of Pennsylvania Health System includes three hospitals,
all of which have received numerous national patient-care honors [Hospital
of the University of Pennsylvania; Pennsylvania Hospital, the nation's
first hospital; and Penn Presbyterian Medical Center]; a faculty practice
plan; a primary-care provider network; two multispecialty satellite
facilities; and home care and hospice.