Mastectomies on the rise and MRI use may explain part of the trend, say Mayo r...(s that MRI which easily detects both can...),Health

What we dont know from this study is whether the higher rate of mastectomy observed in our patients undergoing MRI is related to the detection of additional disease, or whether the uncertainty raised by MRI leads to greater anxiety for the patient and physician, thus leading patients and physicians to choose mastectomy over lumpectomy, says Dr. Goetz.

Although MRI was associated with a higher mastectomy rate, we cannot assume it is a cause-and-effect relationship, says co-author Amy Degnim, M.D., a breast surgeon at Mayo Clinic and an assistant professor of surgery. More investigation at an individual level is needed to understand better how MRI may impact personal choices for breast cancer surgery.

Dr. Goetz says that, while MRI was associated with an increased mastectomy rate, the mastectomy rates also increased in women who did not undergo MRI, suggesting other factors are playing an important role in the decision-making process of patients and physicians.

In the past 10 years, we have observed numerous changes in the preoperative management of patients with breast cancer, says Dr. Goetz. In addition to new imaging modalities such as MRI, more women are familiar with the role of genetics as a risk factor for breast cancer, and some of our patients are undergoing testing. Additionally, there has been improved access to better breast reconstruction methods.

Lumpectomy plus radiation therapy (known as breast conserving therapy [BCT]) has been the standard of care for most women with early-stage disease since 1990. That year, the National Institutes of Health issued a report stating that BCT was as effective as mastectomy for overall survival for most women with st
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