Annual Screening With Both Mammography and MRI Seems Better Than Only Mammography for Women With Personal History of Breast Cancer

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Women who've been diagnosed and successfully treated for breast cancer are at risk for recurrence (the original breast cancer coming back). These women also have a higher-than-average risk of being diagnosed with a new, second breast cancer. Because of these risks, regular breast cancer screening is very important for women with a personal history of breast cancer. A study suggests that yearly screening with BOTH mammography and breast MRI (magnetic resonance imaging) might be better than only a yearly mammogram for women with a personal history of breast cancer.

The American Cancer Society recommends yearly screening with both MRI and mammography for women with an abnormal breast cancer gene (BRCA1 or BRCA2), as well as women with a strong family history of breast cancer. Some doctors also will recommend both types of screening for women who've been diagnosed with breast cancer. Still, current guidelines don't recommend routinely using MRI to screen women with a personal history of breast cancer. This study wanted to see if yearly screening with MRI in addition to mammography would benefit women who've been diagnosed with breast cancer.

The researchers looked at the results of 1,026 breast MRI screenings that were done in addition to a yearly mammogram in two groups of women:

  • 646 women with a personal history of breast cancer
  • 327 women who hadn't been diagnosed but did have a strong family history or an abnormal breast cancer gene

Screening with both MRI and mammography had some benefits for women with a personal history of breast cancer (even though it's not currently recommended) compared to screening with both techniques in high-risk women who hadn't been diagnosed.

MRI in addition to mammography found twice as many cancers in women with a personal history (3.1%) compared to high-risk women who hadn't been diagnosed (1.5%). This difference wasn't significant, which means that it could have been due to chance and not because of the difference in breast cancer history.

Women with a personal history of breast cancer who had MRI also were less likely to need more testing and less likely to have a biopsy that showed a suspicious area wasn't cancer (false positive result from screening) compared to high-risk women with no personal history.

A false positive happens when a mammogram or breast MRI identifies an area that looks like cancer but turns out to be normal. Besides the fear of a breast cancer diagnosis, a false positive usually means more tests (including biopsy) and follow-up doctor visits. The process can be very stressful and upsetting.

In this study, a biopsy confirmed that a suspicious area was cancer in 35.7% of the women with a personal history compared to 12.25% of the high-risk women with no personal history. This means that there were more false positives in the high-risk women with no personal history compared to the women with a personal history.

Many of the breast cancers found in the women with a personal history of breast cancer were found 5 or more years after the first diagnosis. This is why aggressive breast cancer screening should be done throughout a woman's life after she's been diagnosed.

If you've been diagnosed with breast cancer or are at high risk and haven't been diagnosed, you and your doctor should develop a screening plan tailored to your specific situation. If the plan doesn't include breast MRI in addition to regular mammograms, you may want to talk to your doctor about the results of this study and ask if breast MRI makes sense for you.

You can learn more about mammograms and other ways to screen for breast cancer in the Breastcancer.org Screening and Testing section.

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