(surgery and possibly radiation and/or chemotherapy) rather than one, as would be the case if cancer in the other breast was found at the time of initial diagnosis.
Sixty percent of the cancers uncovered by MRI were invasive, with potential to spread beyond the breast. Such breast tumors "are the most important ones to find," Pisano said. The average tumor size was nearly 11 millimeters.
Pisano, director of the UNC Biomedical Research Imaging Center and a member of the UNC Lineberger Comprehensive Cancer Center, said the percentage of cancers found in the opposite breast was huge. "If you were to screen the opposite breast with mammography in the general population, you would expect to find four to seven cancers per 1,000 patients. This study found three per 100, nearly ten times higher."
Smaller, less rigorous studies at a single center had suggested that MRI would detect otherwise hidden cancers in roughly 5 percent of women with a recent breast cancer diagnosis. But the percentages of additional cancers ranged widely, as did the ability of these studies to correctly identify the absence of cancer. Nor did these studies include a one-year follow-up to determine the breast cancer status of the women in whom MRI did not detect disease.
The ACRIN authors note that the additional cancers detected in their study was not influenced by the patient’s breast density, menopausal status or primary tumor history.
"The reason why dense breasts are a problem is that tissue lies between the tumor and the detector. The beam has to go though a lot of normal tissue, which can hide the tumor. But if you take slices, as MRI does, you get images in focus every few millimeters and the tumor can’t hide," Pisano said.
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