Monday, October 11, 2004
Research compares screening methods
By Peggy O'Farrell
Enquirer staff writer
Tina Sansone was diagnosed with breast cancer shortly after the birth of Logan. Photo by: Thomas E. Witte/The Enquirer
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• Survivors keep hope alive
• Cut risk of cancer with good habits
Walkers wanted Sign up now for The American Cancer Society's Making Strides Against Breast Cancer, a 5-mile walk through downtown Cincinnati and Newport Oct. 24. Registration begins at 8 a.m. at Yeatman's Cove downtown, and the walk starts at 9 a.m. Information: (513) 891-1600.
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Mammography remains the "gold standard" for breast cancer screening, but researchers are looking for alternative methods to catch the disease early, a Cincinnati expert says.
A Danish study this summer in the New England Journal of Medicine showed MRI, or magnetic resonance imaging, was more effective than mammography in detecting breast cancer in women with genetic mutations that put them at very high risk.
But women with the BRCA1 and BRCA2 gene mutations are a "very, very small, isolated, tiny group," says Dr. Mary Mahoney, a radiologist and director of the Breast Imaging Center at the University of Cincinnati's Barrett Cancer Center.
Women who are at very high risk for breast cancer should talk to their doctors about whether MRI is a better option, Mahoney says, but mammography is the most accurate option for most women.
Mammography misses about 17 percent of breast cancers. "We know it's not perfect, but it's the best thing we have right now," Mahoney says.
MRI and ultrasound are used mainly as adjunctive tools when mammogram images are inconclusive or more detail is needed on a mass.
Researchers at Barrett are participating in a national study to determine whether ultrasound is more accurate than mammography in detecting breast cancer in women with very dense breast tissue. The study could indicate whether ultrasound could be used as a screening tool for some women, Mahoney says.
MRI is "an exquisite tool" for getting a good image of cancerous masses, but it's not a good choice for screenings, she says: Unlike mammography, MRI is too expensive, too hard to access and invasive.
MRI also has a high rate of "false positive" results, which means women might end up getting biopsies or other tests that aren't necessary.
The most common role for MRI in breast cancer is giving doctors a more accurate picture of newly diagnosed cancers. The imaging tool can give surgeons a better idea of the size and shape of the tumor and can also show whether lesions are present in the breast that weren't picked up by the initial mammogram, Mahoney says.
MRI is also used to evaluate chemotherapy to see if it's effective during treatment, rather than waiting until the regimen is completed, she says.
E-mail pofarrell@enquirer.com
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