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Magnetic resonance imaging, or MRI, alternated with mammography at six-month intervals can detect breast cancers not identified by mammography alone, a research team from The University of Texas M.D. Anderson Cancer Center reports.

MRI is known to be more sensitive in detecting breast cancers than mammography, with a 71 to 100 percent accuracy compared to a 16 to 40 percent accuracy for mammography. As a result, annual breast cancer screening for high-risk women now typically includes MRI along with mammography and a clinical breast exam.

"In the high-risk population, the recent standard of practice is to perform mammography and MRI every year," said Huong Le-Petross, M.D., assistant professor of diagnostic radiology at M.D. Anderson and the study’s first author. "What we started to do at M.D. Anderson was to see if we could do mammography and then six months later do a breast MRI exam, followed six months later with a mammogram exam, and then six months after that with a breast MRI. That way the women would receive screening every six months."

In a pilot study, the researchers reviewed charts of 334 women labeled high-risk for breast cancer who had participated in a breast cancer screening program at M.D. Anderson.

About one-fourth of the women underwent this alternating approach. The remainder of the group had a mastectomy to prevent developing cancer in the future, or began taking medications to prevent cancer. All study participants were given a clinical breast exam every six months.

Nine cancers were detected in the group of women who had alternating MRI and mammography. Five of these cancers were identified by MRI but not by mammography, three were found by both MRI and mammography. One cancer, a tumor one millimeter in size, was overlooked by both screening techniques. No cancer was detected by mammography alone.

"The global picture is that MRI can pick up cancers that mammography cannot," Le-Petross said. "This would suggest that in this high-risk population it is more beneficial for the patient to have screening MRI so that we can pick up small lesions before a mammogram can detect them."

One important unanswered question is whether an alternating MRI and mammography screening program will save lives.

"That is going to take a five- to 10-year follow-up to determine," Le-Petross added. "It is an exciting question because mammography has always been the standard, and now we are challenging that gold standard examination."

Source: http://www.texmedctr.tmc.edu/root/en/TMCServices/News/2009/01-15/Mammography+Combined+with+MRI+Best+for+High+Risk+Women.htm