Traditional mammogram used to detect breast cancer

Since the mid-20th century the World Health Organization reports there has been an increase in the rate of breast cancer among women in developed countries.  For decades, doctors have urged their patients to do a routine self-exam and undergo a breast X-ray, known as a mammogram, every year after age 40.  Now cancer experts say the mammogram may not enough for those women who are at higher risk.  VOA's Melinda Smith has more on the latest recommendation for this special group of patients.

In the United States, an estimated 200,000 women are diagnosed with breast cancer every year.  It is the second leading cause of cancer death among American women.

For the most part, yearly mammograms have helped diminish the death rate.  But a study published in the prestigious New England Journal of Medicine concludes that Multiple Resonance Imaging...known as the MRI...picks up signs of cancer that are sometimes missed by a mammogram or doctor's exam. 

Dr. July Gralow of the University of Washington Medical School says the findings are significant.

"Screening MRI offers incredible potential and we're excited about that potential," she said.

Image of (MRI imaging) breast

A recent diagnosis of cancer in one breast were studied with 969 women subjects.  Mammograms had not picked up abnormalities in the other breast.  But when the women underwent a MRI, cancer in the other breast was detected among 30 of those in the study and confirmed by a biopsy within one year.

The new guidelines apply to an estimated 1.4 million high-risk women in the United States.  That applies to those already diagnosed or whose mother or sisters have had breast or ovarian cancer.   Also included are women who had cancer in childhood and those identified as carrying the breast cancer gene. 

Dr. Elmer Huerta of Washington Hospital Center in Washington, D.C. acknowledges the recommendation may cause some anxiety, particularly among those women who find out they carry the genes.

 “They are going to ask their doctors to have these BRCA-1 and BRCA-2 genes tested, and that's going to create positive things in the sense that we are going to learn a lot:  who is susceptible, and who is not, but also may elicit some fears among the population," she said.  "What are you going to do if you are positive for these genes?"

Multiple Resonance Imaging is not perfect.  It has been known to produce false positives at a higher rate than mammography., but specialists, like Dr. Elizabeth Morris of New York's Memorial Sloan-Kettering Cancer Center, say the benefits are worth it.

"[The] MRI shows areas of abnormal blood flow that can represent early breast cancer. That's not seen on mammography," she said.

MRI's are expensive and not often available in many parts of the United States and around the world.  

 "Even here in the United States, we have 50-million people without health insurance and these people, they have no access--forget about an MRI, which costs up to $2,000 each," Dr. Elmer Huerta adds.

Dr. Huerta believes that women should still do what they can to detect cancer early:  that means practicing a monthly breast self-exam, going to the doctor for regular checkups and after age 40, get a yearly mammogram.