Mammogram, MRI, or Ultrasound?

Women's annual breast exams could be improved by adding ultrasound and magnetic resonance imaging (MRI) scans to the usual mammogram, according to the Journal of the American Medical Association's April 4th issue. The study followed 2,662 women at high risk for breast cancer, particularly because of dense breasts or a family history of the disease. They agreed to undergo three independent screenings in one year, arranged in random order. The three tests found a total of 111 cancers, for about 2.6 percent of the total group.

Mammography turned up 59 cancers, or 53 percent of the total cancers found. Ultrasound found 29 percent of cancers on its own, independent of other tests. MRI scans found a total of eight percent of cancers that the other two methods had failed to detect. Eleven cancers, or 10 percent, were not found by any of the three screening technologies.

Annual ultrasound screening may detect small, node-negative breast cancers that are not seen on mammography. Magnetic resonance imaging revealed additional breast cancers missed by both mammography and ultrasound screening.

Nearly half of the cancers would not have been detected with mammography alone.

Bonnie: this study adds to the increasing body of evidence that this practice has caused a problem for women -- diagnosis of breast cancer that wouldn't cause symptoms or death. Concerns about false positives in mammograms and over-testing has led some researchers to believe less frequent exams may be the answer.