Mammography or Breast MRI – Which is more effective?

According to the World Health Organisation, in 2021, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years.

While it may be the world’s most prevalent cancer, if detected early, there are more treatment options and a better chance for survival. Women whose breast cancer is detected at an early stage have a 93% percent or higher survival rate in the first five years.

Mammography or Breast MRI?

Mammography and Breast MRIs are the primary methods of breast cancer detection – let’s examine both these methods more closely.

In mammography, low doses of radiation are used to image the breast. Mammography is a highly effective tool, and doctors and medical organisations recommend annual mammograms for all average-risk women above the age of 40 years, and for high-risk women above the age of 30 years.

The breast MRI uses a powerful magnet to image the breast, with no radiation exposure. Breast MRIs are typically suggested as a supplementary modality after a mammogram.

Let’s weigh the pros and cons of both methods of screening.

Significance of Mammography:

• Mammography is generally more reliable than MRI when detecting suspicious calcifications (Ductal Carcinoma Insitu – a pre-cancer stage) that, in most cases, indicate the presence of breast cancer. The reason is that calcium readily absorbs X-rays from mammograms and appears as bright white specks on the soft tissue background of the breasts. This can be a very early indicator of breast cancer. Calcifications typically don’t show up on breast MRIs.
• Mammography is best suited for patients with metal implants or pacemakers, since metal implants/pacemakers are contraindicated for a breast MRI.

Cons:

• Most women feel some discomfort because of the pressure exerted on the breasts by the compression paddle system. However, compression is important as it allows the breast tissue to spread and flatten, and keeps the breast firm and steady during examination for better image quality. To address this, the latest Self Tilt compression technology with the least scan time and low dose radiation with Hologic’s mammography system from Blue Star E&E conforms to the natural contours of the breast, providing greater comfort to the patient and more even compression across the entire breast.
• During the procedure, there is a risk of exposure to a small dose of ionizing radiation. However, humans are exposed to ionizing radiation every day from the natural environment. A mammogram exposes a woman to 0.4 mSv, which is what a person would get from natural background exposure over 7 weeks.

Advantages of Breast MRIs

• Breast MRIs are a better choice for high-risk women. After reviewing more recent studies, the American Cancer Society recently recommended that any woman with a greater than 20-25% lifetime risk for breast cancer should consider undergoing screening with BOTH Mammography and Breast MRI. On the other hand, the American Cancer Society recommends against MRI screening for women with a lifetime risk of breast cancer that’s less than 15% percent.
• Breast MRIs are effective even for large tumors, and are shown to be more accurate than physical exams, mammography, or ultrasounds in following the results of chemotherapy to shrink large breast tumors.
• There is no risk of radiation exposure because MRIs use magnetic fields to create images.

Disadvantages of Breast MRIs

• The breast MRI involves a higher cost – nearly around four times more than a mammogram, which is why it is recommended more for women at higher risk for breast cancer or to evaluate details in addition to a mammogram.
• Breast MRIs are also time-consuming and can be a discomforting modality for claustrophobic patients, which is why its routine use for screening general population is not advised.
• Patients with ferrous implants and pacemakers cannot be screened because of the magnetic field generated by an MRI.

In short, the Breast MRI does not substitute a Mammogram but would complement it for certain advised cases. Mammography remains the gold standard for early detection of breast cancer, with a cost cheaper than MRI, yet with higher detection rate (89-97%) of early breast cancer and a higher specificity rate i.e. the ability to correctly identify women without breast cancer.

If you’d like to know more about Mammography equipment or breast MRI screening equipment, give our team at Blue Star E&E a call.