Study: More Women Getting MRIs before Breast Cancer Surgery

MRIMagnetic Resonance Imaging (MRI) is linked to breast implant surgery in that the FDA considers it an effective method of detecting silent rupture of silicone gel-filled breast implants. The FDA recommends that women with silicone gel implants get MRI scans done to detect silent rupture three years after receiving the implant and every two years after that.

A recent Canadian study looked into the use of this screening technique prior to breast cancer surgery and found that the use of MRI in this context has increased eightfold over the past decade. This finding, which applies both to the U.S. and Canada, is alarming as no guidelines support the routine use of preoperative MRI in women diagnosed with breast cancer. It is recommended only as an optional procedure to detect cancers that are missed with other tests.

The Canadian researchers have linked the increased use of MRI before breast cancer surgery to a number of factors:

  • Increase in further testing
  • Longer wait times to surgery
  • A higher possibility of a mastectomy instead of breast-conserving surgery
  • A higher likelihood of having the healthy, opposite breast removed

Numerous health care databases in the province of Ontario were examined by the researchers as part of the study. More than 53,000 women who had been diagnosed with operable breast cancer from 2003 through 2012 were evaluated. Medicinenet reported on the findings of the study which was published online in the journal JAMA Oncology in September 2015:

  • Just 3 percent of patients had the preoperative MRI scan in 2003
  • This proportion had risen to nearly 24 percent by 2012
  • The use of the procedure had risen from about three to 20 times in recent years
  • It is not clear as to how many of the MRI scans were not needed, the reasons being inconsistent guidelines of the use of the technique

One limitation of the study is that the medical records used did not say whether the MRI results were positive or negative. So the extent to which MRI impacted treatment decisions is not clear.

The researchers conclude that in addition to consistent guidelines on the use of preoperative MRI, further research is needed on how to use the results of the scan in treatment decisions. They say that while MRI is a powerful imaging tool, it must be used to provide more customized therapies to women. Women seeking to have a pre-surgical MRI scan must also consult a physician who is specialized in the technique.