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A breast MRI may have saved Christina Applegate’s life. I don’t know exactly why her doctor decided to order it, but showing up for that appointment may have been the best decision that Ms. Applegate ever made. The MRI apparently found a very early breast cancer, and early cancers are relatively easy to treat.
Should those of us with breasts all run to our doctors begging for an MRI? Most of us shouldn’t, but some of us probably should. Women who carry the breast cancer gene are at particularly high risk of breast cancer. In these women, breast MRI has been shown to help find early cancers – a combination of mammography and breast MRI may be the ideal screening regimen for these women.
In a study recently published in the Annals of Internal Medicine, high-risk women were screened using mammography alone, MRI alone, or mammography plus MRI. The sensitivity of mammography alone was only 32%, MRI alone did much better at 75%, but a combination of the two was best with a sensitivity of 84%.
If breast MRI is so fabulous, should we forget about mammograms and get in line for yearly MRIs? Not yet. The problem with breast MRIs is that they have many false positives. That is, the machine thinks that you have cancer when you really don’t. Finding out the truth requires a biopsy (and the terrifying days to weeks leading up to it), which can result in scarring, pain, bleeding and other complications. For most of us the chance that we have cancer is low enough that those risks aren’t worth the expected gain. But for very high risk women, the opposite is true.
Some women know that they are carrying the breast cancer gene. If you do, ask your doctor about getting a breast MRI. But there are many women who carry the gene who are simply unaware. If you have two first-degree relatives with breast cancer, or one who got breast cancer before age 50, this could be a sign that you are carrying the breast cancer gene. First-degree relatives include parents, siblings and children. Since ovarian cancer is also associated with this gene mutation, if you have a close family member with ovarian cancer you might be at risk.
If you think that you may be carrying the breast cancer gene, talk to your doctor and consider getting tested. If you are carrying the gene, get an MRI.
It may be the best decision you’ll ever make.
Be well,
Dr. C.
www.insightmedicalconsultants.com
(AP photo)


