The use of Magnetic Resonance Imaging, better known simply as MRI, for breast cancer screening is increasing and so is its use in guiding breast surgery when cancer is discovered. Obviously, that means healthcare costs are soaring, too, as more and more women are advised to get MRIs in addition to mammograms. The push started in 2007. At that time, the New York Times reported a breast MRI cost $1,000 to $2,000, and sometimes more — at least 10 times the cost of mammography. So for every million breast MRIs performed each year, healthcare costs spike by at least a billion dollars. Sometimes, but not always, these test are covered by Medicare and insurance.
Of course, despite this enormous cost, the only reason doctors and medical centers would be urging women to have these expensive tests is because there must be convincing proof breast MRIs are excellent for spotting breast cancer and/or for directing cancer therapy. But this is not true.
Although it may be hard to believe, here comes the shocking truth, as just reported in the prestigious medical journal The Lancet. Monica Morrow from Memorial Sloan-Kettering Cancer Center, New York, and colleagues meticulously reviewed research from the past decade to examine the belief that breast MRIs are effective at finding and treating breast cancer. What they found was just the opposite. There is little to no evidence breast MRIs benefit the vast majority of women. In fact, there’s not even evidence showing breast MRIs are particularly effective at helping direct breast-conserving surgery.
Selling women on breast MRIs with no proof the tests increase survival
The new study did indicate breast MRI can be valuable in screening women at very high risk for breast cancer due to their genetic heritage. However, let’s take a closer look at that finding. According to a media statement, the researchers noted that while a breast MRI can identify tumors missed by mammograms and ultrasound in women at risk of breast cancer due to a known gene mutation or their family history, “little is known about whether or not this improved detection has any impact on survival.”
“MRI has, over recent years, been widely adopted into clinical practice based on the assumption that its increased sensitivity at detecting cancer will improve outcomes for patients,” the authors noted in a media release. Bottom line: they found there’s no actual evidence having a breast MRI that spots cancer in a high risk woman means they will live any longer than they would have if they’d never had the test.
According to the research team, that fact that breast MRIs produce more sensitive images does not translate into better surgical treatment or prognoses when used to evaluate women before surgery, either. “The available data does not support the idea that MRIimproves patient selection for breast-conserving surgery or that it increases the likelihood of obtaining negative margins [no cancer cells found in margins of resection] at the initial surgical excision,” they wrote.
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