Making strides: New breast MRI is saving lives by detecting cancer earlier

Lucille Peart, a church volunteer who beat cancer in her right breast seven years ago, wasn't expecting the news she got from magnetic resonance imaging this summer.

An MRI found what Peart's annual mammogram and an ultrasound could not: An abnormality in her left breast. A needle biopsy, also guided by the MRI machine, then confirmed that it was cancer.

Peart and her doctors were stunned.

"After the first time, when I finally got to the five-year point, I was happy as a clam and I never really thought about (cancer) anymore," said Peart, 57. "So you could have picked me up off the floor. It never even entered my mind."

Peart was one of the first women to take advantage of the new breast MRI technology that arrived at Brockton Hospital in July. The MRI was suggested by her surgeon, Dr. Julie G. White, because of Peart's history of breast cancer.

White recommended the MRI even though Peart's annual mammogram was clean and an ultrasound of her breasts showed no irregularity. Because the MRI was able to find the cancer so early, it increased Peart's chance of being cured.

"The MRI showed us something we weren't expecting to see," said White, who estimates she sees 50 to 60 new breast cancer patients each year. "It makes her chances of survival much higher than if we waited (for it to appear) on a mammogram."

The breast MRI, which is also available locally at Caritas Good Samaritan Medical Center in Brockton, is a new and still controversial technology.

It can't replace mammography because it is so sensitive that it picks up too many questionable spots in the breast, leading to needless biopsies and expense and inconvenience for patients, doctors say.

But as a diagnostic tool, for women who have suffered from breast cancer in the past or have a history of it in their families, the breast MRI is proving its worth.

"Most community hospitals will be doing breast MRIs within the next few years," said Dr. Warren Salzman, assistant director of the Department of Radiology at Brockton Hospital. "It is very sensitive. In (Peart's) case, it picked up something that wouldn't have been seen on a mammogram."

Peart said the breast MRI, about a 45-minute procedure, was not painful. She had to remain immobile on her stomach throughout, with her breasts resting in two open cups on the MRI machine.

"Having had breast cancer and radiation, you're left with scar tissue, which makes a mammogram even more painful," Peart said. "The MRI is not painful at all."

A grandmother of five and a volunteer at Christ the King Church in Brockton, Peart lives in Brockton with her husband of 37 years, John.

Having undergone a lumpectomy, she is scheduled to begin daily radiation treatment next week. Because her cancer was detected so early, chemotherapy won't be part of the regimen this time.

"I'm still dealing with anger and sadness," Peart said. "I didn't want to be in this position again. But I have every confidence these people are going to get me through this again."

Breast MRI Pros and Cons

Advantages:

<ul>

<li>Evaluating a woman who has a palpable mass not visible with ultrasound or mammography.</li>

<li>Assessing a lesion in the densely glandular breast of a young woman.</li>

<li>Screening a young woman who is at high risk for cancer because of a significant family history of breast cancer or an abnormal gene.</li>

<li>Determining the precise site of cancer's origin in the breast of a women who has breast cancer cells in an underarm lymph node, but no breast mass that doctors are able to feel or see on a mammogram.</li>

<li>Determining if cancer is limited to one area of the breast, or if it is "multicentric" and involves more than one area.</li>

<li>Evaluating scar tissue and detecting leakage from a breast implant.</li>

</ul>

Disadvantages:

<ul>

<li>If you're claustrophobic, being confined within an MRI machine for up to an hour can be difficult.</li>

<li>The value of MRI for breast cancer detection remains uncertain. Some doctors believe MRI can distinguish a breast cancer from normal breast gland tissue better than other techniques.</li>

<li>MRI is expensive and requires highly specialized equipment and highly trained experts. Relatively few MRI centers exist, especially outside of major cities.</li>

<li>Even at its best, MRI produces many uncertain findings.</li>

<li>MRI can dislodge certain metal devices, such as pacemakers, in some people.</li>

</ul>

Source: www.breastcancer.org