How MRI Scans Find Breast Cancers Like Christina Applegate's
When I first heard that actress Christina Applegate had breast cancer, I wondered how the 36-year-old's tumor was detected. Did she find the lump herself, or did her doctor feel it during a regular checkup? Perhaps Applegate was diagnosed via a screening mammogram, like my 37-year-old friend, Panina. Turns out, Applegate's tumor was detected through magnetic resonance imaging, which was ordered by her doctor, according to her publicist. That decision could prove lifesaving because the cancer was caught early—when it's most likely to be cured.
The exquisitely sensitive MRI is very good at detecting tumors in young women whose dense breast tissue often hides tumors on mammogram X-rays. But it's very expensive and all-too-frequently detects false abnormalities that necessitate biopsies. For this reason, the test is recommended only for those at increased risk of breast cancer. (Breast cancer is very uncommon in those under 50, so it would be foolhardy to screen all women in their 30s.) News reports disclosed that Applegate's mother had previously battled breast cancer, but that by itself isn't usually enough to justify an MRI in a woman so young. Last year, the American Cancer Society issued recommendations for the use of MRI screening for women at increased risk of breast cancer, as my colleague Katherine Hobson previously reported. You should have an annual test if you fall into one of these categories:
1. You have a BRCA1 or BRCA2 gene mutation.
2. Your mother, sister, or daughter has a gene mutation, and you haven't been tested.
3. You have a lifetime risk of breast cancer of at least 20 percent using this widely accepted risk assessment tool.
4. You received radiation treatment to the chest between ages 10 and 30 for conditions such as Hodgkin's disease.
5. You carry or have a first-degree relative (parent, sibling, child) who carries a genetic mutation in the TP53 or PTEN genes responsible for these conditions: Li-Fraumeni syndrome; Cowden syndrome; Bannayan-Riley-Ruvalcaba syndrome.
Other women who have a personal history of breast cancer or precancers or who have extremely dense breasts, says the ACS, could also benefit from screening MRIs and should talk to their doctor about whether they should get screening.
Tags: breast cancer | medical screening | women's health
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Reader Comments
Ms Kotz,
Unless you are a survivor or doctor - do not attempt to write about a subject that you know little about. I had none of the categories that you suggested, yet at 41 I was diagnosised with stage two breast cancer. I thank my doctors for allowing yearly mammograms since I was 35. The all clear mammogram before my dianosis was only seven months apart.
I was just diagnosised with a second breast cancer (nine years later). Also thanks to the mammogram and a very dilagent radiologist.
This last time I went through mammograms, ultrasounds, MRI and finally PEM scan. The PEM scan is new on the scene. Better than the MRI and can tell without a biopsy if you have cancer. Unfortunately insurances still require a tissue biopsy if you plan to have a mastectomy.
Bottom line - Get your mammogram. Do it even if you are not likely to have cancer. Do it even if you are younger than 40. Do it, even if you have a false positive - better that than dead. Just do it.
And frankly as I have told all my friends at least I will have perky breasts the rest of my life while theirs are sagging.
Age of onsent
Cory is right. Breast cancer isn't "uncommon" in women under fifty. It's just not AS common.
I applaud Applegate's physician. This game of "playing the statistics," of not doing tests because of age (young or old) actually says that we are willing to sacrifice those people who don't follow the statistical pattern. We just saw it today in another way; now they want to deny PSA tests to older men because SOMETIMES prostate grows slowly. Well, it didn't grow slowly in my father, who was 69 -- not all that far from 75 -- when he died of prostate cancer. I guarantee you he would have preferred a PSA and a biopsy. Then he would have found out that although SOME old men can play "wait and see," he needed to treat his aggressively. My BIL also had an aggressive type of prostate cancer that was caught in time, and I guarantee you that had he been 75 he still would prefer to live.
Statistics tall us about groups of people -- not individuals. Thank goodness Applegate is around to show us to look at ourselves as individuals and not statistics.
By the way, they caught Applegate's cancer early, which is really important in younger women in particular.
we deserve more details
It would be very helpful if Applegate would allow her physicians to come forward and describe the process. It does seem odd that her cancer was detected via MRI and I too wondered if there wasn't something else to the story. Rather than allow misinformation to be propagated, the docs should explain. Applegate went public, there should be no reason why the specifics can't be revealed
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