Mammogram vs MRI

DeeUK · 06-19-2006, 09:19 AM

I wonder if some of you could give me some advice on this please..

I've been informed that the hospital will be contacting me soon, for my '1 year post diagnosis mammogram'.

I'm 30, and I know mammograms tend not to be as reliable for younger people.
When they contact me, I intend to ask about the possibility of an MRI, instead.

I'm in the UK, and as far as I know, the majority of hospitals only offer mammograms. I have a feeling they're going to refuse to give me an MRI.
If they do refuse, I'm prepared to pay for it myself, if it's going to have a better chance of picking up any abnormalities, than a mammogram would.

I could do with a little guidance on this, so I'm armed with some information and knowledge, to face the medical folks with.
I'd really appreciate any help, advice and info, anyone may be able to give me

Bev · 06-19-2006, 07:06 PM

Hi Dee,

I had my 1 year mammogram and will be having an MRI in Oct. I think the plan is to alternate them every 6 mos for a while.

I would think at your young age, your breasts will be too dense to get a get a good view with the mammo. I had a 2.9 cm tumor turn up 5 mos after a mammo so I don't have a lot of confidence in them.

Definitely ask for an MRI. If you are only allowed a mammo try to get a newer digital machine. They're clearer images than film.

Good Luck, BB

mekasan · 06-19-2006, 07:58 PM

i second the MRI vote over the Mammo.

AlaskaAngel · 06-19-2006, 08:16 PM

NEW YORK (Reuters Health) - Magnetic resonance imaging (MRI) is "significantly more sensitive" than mammography in detecting multiple malignant foci in fibroglandular or dense breasts but not in fatty breasts, according to findings from The Italian Trial for Breast MRI in Multifocal/Multicentric Cancer published in the October issue of the American Journal of Roentgenology.

Dr. Francesco Sardanelli from the Istituto Policlinico San Donato in Milan and colleagues compared the sensitivity of MRI versus mammography for detecting additional malignant lesions in 90 women with breast cancer scheduled to undergo mastectomy (9 bilateral, 99 breasts).

Additional malignant lesions were detected more often by MRI than by mammography (152 vs 124). Pathologic examination of the whole excised breast -- the gold standard -- detected 188 additional malignancies.

According to Dr. Sardanelli, the malignancies that were missed by mammography were "significantly larger and more aggressive (70% were invasive cancers) overall than the malignant areas that were missed by MR."

MRI was most useful in women with dense breast tissue. In fibroglandular or dense breasts, the sensitivity was 81% for MRI versus 60% for mammography.

However, false-positive results remain a problem for both techniques, which have a "relatively low" positive predictive value, the authors report. The overall positive predictive value of 68% for MRI was not significantly different from the positive predictive value of 76% for mammography.

Previous studies have shown that up to 42% of women diagnosed with breast cancer in one breast have at least one other malignant lesion in the same breast. It's important to identify these other malignant areas to determine the best course of treatment, the authors note.

Based on the current findings, Dr. Sardanelli and colleagues believe that it would be worthwhile to perform a "dynamic MRI examination before treatment planning in patients with a nonfatty breast pattern."

The findings of the current study support those of several previous studies showing that MRI is more sensitive than mammography in the detection of breast cancer. (see Reuters Health reports September 15 and July 28, 2004, among others).

Am J Roentgenol 2004;183:1149-1157

mts · 06-20-2006, 05:17 AM

I also agree that an MRI is far better. After my initial bc diagnosis I joined a multi-modality trial at the University of Pennsylvania. The physical imaging they were comparing were mammos, ultrasound and breast MRI. Well, The MRI picked-up two tumors that neither the mammo or ultrasound saw. The MRI saved my life. The mammo they used was digital too. Plain and simple, if you have dense breasts (which most younger women have, then the MRI is the way to go. The one thing that MRI's do not pick-up are calcifications (which the mammo easily does). In the end, as useless as the mammo may be, it is still a good idea to get the mammo and ALSO the breast MRI.

Also, if you have scar tissue, this can mimic cancer on the MRI. Make sure you have the best person around to read your results. Preferably the radiologist (not the tech) will be in the adjacent room while you are getting your MRI.

Best to you,
Maria

tousled1 · 06-20-2006, 05:33 AM

I agree that the MRI is the best route, especially for dense breasts. The MRIs pick up much smaller tumors than does a mammogram.

DeeUK · 06-20-2006, 06:14 AM

Thank you all for your advice

I'm going to print the article and take it with me next week. I'm going to see my breast care nurse to talk about a few things, and this is on my list.

And thanks Maria, for the info about MRIs/mammograms and calcifications.. I didn't know that.

I've just been speaking to someone who's 13 years older than me. Her 4.6cm tumour didn't show up on a mammogram! Doesn't fill you with much confidence about them, does it!

Thanks again for all your help

Love & hugs,
Dee
xxx