Study bolsters case for breast MRI screening

Breast MRI is far superior to x-ray mammography for picking up ductal carcinoma in situ generally and for spotting high-grade early-stage disease, according to Dr. Christiane Kuhl and colleagues at the University of Bonn.

They enrolled 7319 women who underwent mammography and MRI in a screening setting. Of these, 167 received both imaging tests preoperatively and had a biopsy-proven diagnosis of DCIS without associated invasive breast cancer. Mammography detected 56% and MRI detected 92% of all DCIS. MRI detected 98% of high-grade lesions compared with 52% for mammography (Lancet 2007;370:485-492).

An editorial in the same issue suggested MRI should no longer be seen as an adjunct to mammography but as a screening modality in its own right. Study authors warned against quick conclusions, however, noting that few radiologists can offer MRI with the level of expertise required for diagnostic mammography.