MRI is doctors' latest tool for early detection

By Debra Melani, Special to the Rocky

Published September 28, 2008 at 3 p.m.

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Michaelene Harrington went in for an experimental breast-cancer screening last year thinking about her daughters and other women as much as herself. She was 68, four decades past the age when one of her daughters was diagnosed with the disease, which will strike more than 180,000 American women this year.

Maybe she'd dodged the killer that had claimed her grandmothers and many aunts and cousins on both sides of her family. Her annual mammogram only four months earlier had come back clean.

But the retired nurse always was up for furthering research. So she went in for the test, asking for the results right away.

Cancer. Both breasts. An MRI detected what a mammogram did not.

"They told me it was a very aggressive type of cancer and that if we had waited until my next mammogram, it probably would have been too late," said the Centennial resident, who opted for a double mastectomy because of her family history.

Sunday, when thousands of runners take to the streets of Denver in the Susan G. Komen Race for the Cure, Harrington will mark one year post-surgery. She wants to remind women that early detection and continued developments in screening are critical.

The MRI that she considers a lifesaver is increasingly being used by doctors and hospitals to detect or diagnose breast cancer. And the American Cancer Society has begun recommending MRI (Magnetic Resonance Imaging) for routine screening in high-risk women (see side box).

Digital mammograms, while still recommended for only a select group, are proliferating in medical facilities, as more women are requesting the technology, and more doctors are finding benefits.

Dr. Christina Finlayson, director of the Breast Center at the University of Colorado Health Sciences Center, emphasized that the MRI recommendation is in conjunction with - not instead of - an annual mammogram.

"Mammograms can still pick up cancers that an MRI cannot," she said.

Finlayson also stressed that screening recommendations for average-risk women have not changed (see side box) and that digital mammograms have been shown to have possible benefits only in densely breasted women (which most often translates to pre-menopausal women). She said women should talk to their own doctors about what's best for them.

But Dr. Stan Smazal, a radiologist with Porter Adventist Hospital, has been using the digital technology for two years and said he would not go back. His hospital and practice, Radiology Imaging Associates, are nearly converted to all digital machines, he said.

"There's generally more ability to see changes in women," Smazal said. "There are very subtle lesions that do become more conspicuous." He predicts research to continue to confirm its benefits.

Smazal admitted that digital mammography (imaging on a computer) is more expensive than regular mammography (imaging on film), but he said insurance companies are increasingly willing to pay for it.

Harrington said she makes sure her three daughters get the latest in screening, including the one diagnosed 19 years ago at age 28.

"You cannot put a price on someone's well-being," Harrington said. "If it takes an MRI to show that it's cancer or not cancer, it's worth every penny."

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