Two breaking news stories point to the effectiveness of MR in breast imaging.

New guidelines from the American Cancer Society recommend MRIs as well as mammograms for women at high risk for breast cancer. Doing MRI scans on this high-risk group as a regular procedure could add up to almost 1.5 new scans every year. (See related story, "Breast MRIs Urged for High-Risk Women.")

The New York Times reports that the medical imaging industry outside of urban research hospitals is not equipped to handle the increased number of MRIs that the new recommendations support. What's more, clinicians are inconsistent in their recommendations for MRIs, and insurers, including Medicare, are inconsistent in reimbursements for the studies.
In related news, a new study from the ACR and NIH supports MR for patients newly diagnosed with breast cancer. Magnetic Resonance Imaging (MRI) scans of women who were diagnosed with cancer in one breast detected over 90 percent of cancers in the other breast that were missed by mammography and clinical breast exam at initial diagnosis, according the study. Given the established rates of mammography and clinical breast exams for detecting cancer in the opposite, or contralateral breast, adding an MRI scan to the diagnostic evaluation effectively doubled the number of cancers immediately found in these women.

The American College of Radiology Imaging Network (ACRIN) study, supported by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), appears in the March 29, 2007 issue of the New England Journal of Medicine.*

"One in ten women diagnosed with cancer in one breast will develop the disease in the opposite breast. Having a better technique to find these cancers as early as possible will increase the chances of successful treatment," said NIH Director Elias A. Zerhouni, M.D.

The ACRIN trial was designed to determine whether the use of MRI could improve upon clinical breast exam and mammography in detecting breast cancer in the opposite breast at the time of the initial breast cancer diagnosis. The study recruited 1,007 women from 25 institutions who had a recent diagnosis of cancer in one breast. 969 women completed the study, which began in April 2003. All of the women enrolled had a negative mammogram and negative clinical breast exam of the opposite breast within 90 days prior to the MRI. Of the 33 contralateral breast cancers diagnosed in the study, 30 cancers, or 91 percent, were diagnosed as a result of MRI. Researchers found that the added benefit of MRI was consistent, regardless of a woman's cancer type, age, or breast density.

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