MRIs Aren't a Magic Bullet for Breast Cancer Detection

In the quest to find breast cancer early, all eyes now appear to be focused on magnetic resonance imaging (MRI). The drumbeat grew even louder when, earlier this year, the American Cancer Society released new breast cancer screening guidelines recommending that high-risk women receive an annual MRI along with their mammogram. Yet no study has yet shown that finding cancer with MRIs before it might be found on mammography will actually save more lives.

Having had it pounded into us for years that the best way to survive breast cancer is to find it early, the previous statement undoubtedly sounds at best counterintuitive or at worst heretical. But the fact is that many of the tumors found by MRI -- and mammography -- are probably harmless.

Why aren't we trying to find ways to prevent these cancers from even occurring so that women won't ever need to have surgery? It's because it's easier and more lucrative for the research-industrial-medical complex to improve on what we have (me-too drugs, for example) than to explore completely different approaches to the problem. What if we could squeeze a drop of fluid from our breast ducts, where all breast cancer starts, and put it on a dipstick? If the stick turned blue, you would know that you had the conditions in your breast that might lead to cancer. What if breast cancer, like cervical cancer, is actually caused by a virus, and a vaccine could be developed to prevent it? What if we could treat breast cancer by putting chemotherapy into the breast ducts?

We need to foster more doctors and researchers who are willing to look at breast cancer with fresh eyes and without preconceived notions, and we need a mechanism to fund them to test their ideas. Women should not be clamoring to be classified as high-risk patients in order to get MRIs; instead, they should be demanding high-risk research that has the potential to bring us closer to our goal: ending breast cancer. Now.

(The full text of this article appears in the Fall issue of Ms., in which the magazine celebrates its 35th anniversary. The issue is now available on newsstands and by subscription from www.msmagazine.com.)

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