updated 3/28/2007 12:13:40 AM ET 2007-03-28T04:13:40

The American Cancer Society is recommending MRIs in addition to mammograms for certain women considered to be at unusually high risk for breast cancer. Here are more details:

Who should get an MRI?

  • Those with a mutation in the BRCA1 or BRCA2 genes
  • Those who were treated for Hodgkin’s disease
  • Those with a strong family history of the disease, such as women with two or more close relatives who had breast or ovarian cancer or who have a close relative who developed breast cancer before age 50. Experts say about 1 in 50 adult U.S. women fall into this category.

Also, a new study suggests MRI is useful for women diagnosed with cancer in one breast. MRIs turned up tumors in the second breast that other techniques had missed.

Why is an MRI necessary?
MRIs are better at showing increased or abnormal blood flow in the breast, a sign of early cancers not visible on mammogram. They also are better than mammograms at detecting cancer in women with dense, non-fatty breasts.

Why do I still need to get a mammogram, then?
Mammography is considered a very good diagnostic technique, and it can show things MRIs miss, like calcium deposits, which are usually benign but which can occur in patterns that indicate breast cancer.

What are the downsides of MRI?
They make mistakes — one estimate is 5 percent to 25 percent of MRI positive tests are wrong. That can lead to unnecessary biopsies and mental anguish. And they are expensive, costing $1,000 to $2,000. Not all insurers will pay for them.

Also, the test can take an hour or more and requires lying in a tunnel-like scanner.

How do I choose an MRI testing facility?
Some medical facilities that offer MRI lack the expertise and equipment to do MRI-guided biopsies, meaning the MRI will have to be repeated elsewhere if a positive result is found. The cancer society says breast MRIs should be done at places that do biopsies as well.

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