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Is a Mammogram or MRI Best For Breast Cancer Testing?

Mammography is the most widely used screening test for breast cancer; but in the last few years more interest has focused on using breast MRI for breast cancer screening – particularly for women at high risk for breast tumors. Why the enthusiasm about using breast MRI to screen for tumors of the breast?

Breast MRI studies offer two main advantages over mammography. MRI doesn’t involve exposure to radiation, and it’s more sensitive – meaning it can pick up breast cancers that mammograms miss. Still, not all doctors are enthusiastic about using breast MRI as a screening test for breast cancer.

MRI Breast Cancer Screening: Is Using Breast MRI to Diagnose Breast Cancer Better?

Previous studies looking at MRI for breast cancer screening showed MRI to be very sensitive for picking up breast tumors, even ones that mammography missed. The problem lies with its specificity. Breast MRI’s often picks up breast changes that are not actually cancer. This can lead to unnecessary biopsies, which is anxiety-provoking for most women.

A new study looking at the sensitivity and specificity of MRI for breast cancer screening showed that the specificity of breast MRI may be higher than what experts had previously thought.

In a study published in the Journal of Clinical Oncology, researchers found the sensitivity of breast MRI to be 93% with a specificity of 98%. This means that a breast MRI misses breast cancer only seven percent of the time and in only two percent of cases does the abnormality turn out to be something other than a breast cancer – making it much more sensitive – and just as specific as mammography. Based on this study alone, using breast MRI to screen for breast cancer would seem to be a superior screening test to mammography.

The Problems of Using Breast MRI to Screen for Breast Cancer

Despite its ability to pick up breast tumors that mammograms miss, using breast MRI to screen for breast cancer is not without its drawbacks. The biggest problem is standardization. Breast MRI is not widely used at this point, and there’s a lot of problem with the quality of the films and the way they’re interpreted. Breast MRI is also more time-consuming to perform and cost more than mammograms. Right now, most doctors recommend them only for women at high risk for breast cancer – and, when they’re used, it’s usually in conjunction with mammography.

Who Should Use MRI for Breast Cancer Screening?

Women at high risk for breast cancer should talk to their doctor about breast MRI screening, since MRI is more likely to pick up a breast cancer at an earlier stage than mammography.

Some women at high risk refuse to get a breast MRI study because they fear being in a enclosed space. Unfortunately, a breast MRI can’t be performed using an open system at this point. Hopefully, this will change in the future.

Breast MRI to Screen for Breast Cancer: The Bottom Line?

Women at high risk for breast cancer who choose to have a breast MRI should have it done at a center that can do MRI-guided biopsies. If not, the procedure could have to be repeated somewhere else if it shows an abnormality. Right now, breast MRI is only recommended for women at high risk, but this test shows promise, particularly if future studies confirm its specificity.

Dr. Kristie


J. Clin. Oncol. 2010, Mar 20; 28: 1450.

American Cancer Society website.

This article is intended to convey general educational information and should not be relied upon as a substitute for professional healthcare advice.

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