Dr. Lehman on Breast MRI and Mastectomy

Constance D. Lehman, MD, PhD, Vice Chair, Radiology Department, University of Washington School of Medicine, Medical Director, Imaging, Seattle Cancer Care Alliance, discusses how imaging can guide a women with breast cancer to make treatment decisions.

Lehman says that she has noticed a trend towards women opting for mastectomy rather than breast conservation surgery. Some physicians across the country were concerned that this trend was due to MRI in the sense that it could show more disease than expected on mammogram or ultrasound. In this situation, women may make a quick decision rather than wait to determine the best course of action.

The American College of Radiology Imaging Network (ACRIN) conducted a study in which women who underwent breast MRI at the time of diagnosis were analyzed. The study found that younger women, women with family history of breast cancer, and women with DCIS were all more likely to have mastectomy.

The study did not show that breast MRI was correlated with mastectomy, Lehman says. These findings are reassuring, Lehman says, as she does not want women to make decisions on mastectomy based on a suspicious MRI.