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As a radiologist who specializes in breast imaging at Torrance Memorial, I try to be up-to-date on health news.  As a physician, a mother of a daughter, an educator and having women friends, I want to share with you two recent and exciting new developments that will have a significant impact on the diagnosis and treatment of breast cancer. These new developments involve breast MRI imaging.  Most women know that mammograms are images of the breast obtained by using low-dose x-rays, exposing women to a certain amount of radiation.   Breast MRI uses a superconducting magnet instead of x-rays to image the breast without risk of radiation exposure. Moreover, breast MRI sees things that are invisible on mammograms and even ultrasound.  

First, The American Cancer Society (ACS) has just released new guidelines recommending both MRI scans and mammograms once per year for women considered to be at high risk.  High-risk women are those who have had breast cancer in at least one breast,  have a positive gene for breast cancer, family history with at least two first-order relatives, prior diagnosis of certain breast conditions among them “atypical ductal hyperplasia” and prior radiation therapy to the chest for lymphoma. Women with any of these indications have a much higher chance of developing breast cancer than the general population.
To find out more about your own risk, contact the Cancer Resource Center at Torrance Memorial (310-325-9110).

The second new development is a study published in The New England Journal of Medicine (March, 2007) concerning women newly diagnosed with breast cancer in one breast.  Because of dense breast tissue often found in younger women, or because of certain types of cancer that are difficult to see using mammograms, the study revealed that mammograms alone may not be the most effective method of detection. Newer digital mammograms are improving sensitivity in detecting breast cancer. However, MRI will still detect cancers not seen, even on digital studies.  

MRI also changes the management of breast cancer and again that’s great news for a woman’s prognosis. At Torrance Memorial Medical Center, all women with newly diagnosed breast cancer have an MRI exam prior to initial treatment. This enables accurate assessment of tumor size and location and evaluates the remainder of the affected breast and the opposite breast for additional cancers. It allows better treatment planning prior to surgery or chemotherapy and is used in follow-up evaluations.


No one test provides a 100% diagnosis.  MRI’s are not perfect. They are highly sensitive detecting 95% of breast abnormalities but not all are cancers. Therefore MRI’s detect “false positives” and require further evaluation that is both emotionally and monetarily expensive. Using ultrasound after the MRI to reevaluate these false positive areas often clears up the problem. Women still need monthly breast self exam, annual physician’s physical exams and annual mammography. They may also need ultrasound, biopsies and now MRI because each provides physicians with valuable and different information.

In many areas, it may be difficult to find an MRI scanner with breast-scanning abilities and experienced physicians that know how to read these studies. That’s not the case at Torrance Memorial because we have been offering breast MRI as part of a comprehensive breast cancer program for over two years.  Some insurance companies are now paying for MRI studies for those patients who are considered to be high risk and most reimburse in cases of diagnosed breast cancer.  This is great news for everyone, because insurance companies appear to be understanding that they ultimately save money by finding the disease early and fully evaluating it rather than paying for aggressive treatments later.

The recommendations by the America Cancer Society remain the same for the majority of women who are not at high risk:  annual physical exams and mammograms.  For women age 40 and over with no family history of breast cancer, annual mammograms are still the most accurate method of early detection. It is critical to know that MRI does not replace mammography especially because one of the most common types of early breast cancer called “ductal cancer in situ” is not always seen with MRI.

Please, share this information about MRI and its role in screening and management of breast cancer with your friends, family, and health care professionals.  At Torrance Memorial, we feel our responsibility and duty is to educate patients and the community about the latest technology and services
so you can help make informed decisions regarding your healthcare.  And remember this very important fact: women diagnosed with breast cancer at its earliest stages have the best chances of cure and survival.  Now that’s good news for women everywhere.

Dr. Patricia E. Sacks is the medical director of the Vasek & Anna Maria Polak Breast Diagnostic Center.