by Lynn Shapiro
, Writer | February 18, 2009
Updated guidelines that represent best practices for physicians using magnetic resonance imaging to newly diagnose breast cancer and to make treatment decisions for breast cancer were published Feb. 16 in the Journal of the National Comprehensive Cancer Network. Breast radiologists and surgeons at the Seattle Cancer Care Alliance (SCCA) and the Roswell Park Cancer Institute in Buffalo, N.Y. authored the paper upon which the guidelines are based.
The SCCA breast imaging program led by Connie Lehman, M.D., has established itself as a national leader in breast MRI based on pioneering research it has published in the past few years. Lehman is corresponding author of today's journal paper, "Indications for Breast MRI in the Patient with Newly Diagnosed Breast Cancer." The study summarizes an extensive review of published, peer-reviewed studies.
Among the key recommendations:
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* MRI is not a substitute for screening or diagnostic mammography and, when indicated, diagnostic breast ultrasound. MRI supplements the use of these standard imaging tools in appropriately selected clinical situations.
* For women with diagnosed breast cancer, MRI provides enhanced detection in both the breast known to have cancer and the opposite, or "contralateral," breast.
* Surgical decisions should not be based solely on MRI findings because not all suspicious lesions on MRI are cancer. Suspicious lesions should be biopsied before a surgery plan is devised in order to avoid surgical overtreatment.
* In the rare instances where cancer is found in the lymph nodes but not the breast, an MRI can find the location of cancer in the breast in nearly 60 percent of women.
"Exciting research over the past decade makes it clear that breast MRI finds cancers that are missed by mammography and ultrasound," said Lehman, who is the director of radiology at the SCCA and a professor at the University of Washington School of Medicine. "The next phase of research is to understand more completely the impact of this improved cancer detection on treatment outcomes."
The journal is published by the National Comprehensive Cancer Network, a non-profit alliance of 21 of the country's leading cancer centers. Cancer guidelines published by the NCCN are the most widely used in oncology practice throughout the world. The SCCA is a member.
Co-author of the study is Benjamin Anderson, M.D., a professor of surgery at the University of Washington and director of the SCCA's Breast Health Clinic.