Meiyi Research Begins to Challenge the Value of Breast MRI Scanning

A study published in the August 2009 issue of the *Journal of the American College of Surgeons* suggests that breast MRI scans may be associated with increased rates of mastectomy and delayed treatment for some women. Led by Dr. Richard Bleicher from the Fox Chase Cancer Center in Philadelphia, the research examined 577 patients who had undergone various breast treatments. Of these, 130 had received an MRI before their procedures. The findings revealed that patients who underwent MRI scans began treatment about 22 days later than those who did not. This delay could impact outcomes, especially for patients with aggressive forms of cancer. Additionally, the study found that breast MRIs were linked to a higher likelihood of choosing mastectomy over less invasive options like lumpectomy. The conversion rate from breast-conserving surgery to mastectomy was 9.8% for those who had MRIs, compared to 5.9% for those who did not — indicating that MRIs did not reduce the risk of more extensive surgery. Interestingly, younger women were more likely to receive MRIs (average age 52.5 years) compared to older patients (average age 59), despite this group not necessarily having higher risk factors such as family history of breast or ovarian cancer. The study also found no improvement in the rate of positive surgical margins after breast tumor removal — 21.6% of patients who had MRIs still experienced this issue, compared to 13.8% without MRIs. At the 2008 American Society of Clinical Oncology meeting, another large study involving over 5,000 women showed that more than half of those who had MRIs opted for mastectomy, compared to only 38% of those who did not. These conflicting results highlight the need for careful consideration when recommending breast MRI, particularly in low-risk patients. While MRIs can offer valuable diagnostic information, they may also lead to unnecessary interventions and delays, which could affect patient outcomes. As always, individualized care and informed decision-making remain essential in breast cancer management.

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