Advanced screening protocols: new technologies aim to boost breast MRI's specificity.(Gynecology)

SAN ANTONIO -- Recent technologic advances in breast MRI will likely overcome what until now has been the imaging procedure's Achilles' heel, namely, its limited specificity, Dr. Bruce L. Daniel said at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.

It's well established that gadolinium contrast-enhanced MRI is more sensitive than mammography for detection of invasive breast cancer. Unlike mammography, MRI provides tomographic images independent of breast density.

The problem, however, is that breast MRI has a high false-positive rate. One recent review put MRI's specificity for breast cancer at 65%. Others have reported specificities as low as 30%, depending upon the study population's underlying breast cancer risk. This limited specificity leads to unnecessary painful and costly breast biopsies for what prove to be benign lesions.

Moreover, when used as a cancer-staging tool in the ipsilateral breast, MRI results in a significant proportion of women who could benefit from breast-conserving therapy being denied this option inappropriately, explained Dr. Daniel of Stanford (Calif.) University.

Radiologists have pursued two themes in attempting to enhance breast MRI's specificity. In the United States, the effort has focused on taking very-high-resolution images because it's known that lesion ...