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When a patient has an MRI exam, thou-sands of sectional images are taken, and then evaluated and enhanced through the CAD system. A final interpretation by a subspe-cialty trained radiologist provides clini-cians with a number from one (normal) to six (known cancer) using a national scor-ing system called BIRADS—Breast Imag-ing Reporting and Data System. The BIRADS score helps doctors deter-mine the best follow-up examination and appro-priate course of treatment for the patient.

Breast MRI can be helpful in these situations:

Imaging dense breast often found in •younger women and those with fibro-cystic breast changes when mammog-raphy and ultrasound fail to detect or characterize a palpable abnormality.Determining the extent of a known •cancer. MRI is the most sensitive and specific method for complete local stag-ing of breast cancer. Differentiating between surgical scar •and recurrent cancer in patients who

More than 190,000 women in the United States will hear that they have breast cancer this year,

according to the American Cancer Soci-ety. The disease accounts for about 40,000 deaths annually. The numbers are declin-ing, thanks to advanced screening, diag-nostic and treatment options.

According to Duncan Rougier-Chapman, MD, co-director of Breast MRI Services at Wake Radiology, mammography continues to be the only proven modality demonstrated to decrease breast cancer mortality and is the gold standard for screening in the indus-try. However, magnetic resonance imaging (MRI) offers better detection for some forms of the disease, and has been recommended by the American Cancer Society for screen-ing in certain high-risk populations.

How MRI Uncovers CancerMammography uses X-ray radiation, while MRI creates images using magnets and radio waves. To get detailed views of the breast, MRI combines state-of-the-art three-dimensional imaging with comput-er-aided detection (CAD) to look deep into the breast to uncover abnormalities.

have already been treated for breast cancer.Identifying cancer, not detected by •mammography, in high-risk patientsEvaluating response to cancer •treatment.“When used in conjunction with the clin-

ical exam, mammography and sonography, breast MRI can result in improved patient management and better treatment plan-ning for women with known breast malig-nancies,” explained Dr. Rougier-Chapman.

Undergoing MRI ScanningDuring breast MRI, which takes 30 to 40 minutes, patients are comfortably posi-tioned face down on a table and moved into the MRI machine. They are given an intra-venous injection that enhances images and causes tumors to light up. Images are taken of both breasts simultaneously before and after the contrast agent is administered so that the images can be compared.

There are some scheduling restrictions

for a breast MRI because the exam is very sensitive to hormonal changes, so pre-menopausal patients and women taking hormone replacement therapy (HRT) need to schedule their examination dates based on the radiologist’s recommendations.

Dr. Rougier-Chapman noted that breast MRI does not replace screening mammo-grams, as recommended by the American College of Radiology and American Soci-ety of Breast Surgeons. Women who have Breast MRI should continue to have an annual mammogram, or as recommended by their physician.

For more information about breast cancer, visit the American Cancer Society at cancer.org, the National Cancer Institute at cancer.gov or the Susan B. Komen Breast Cancer Foundation at komen.org.

An online test can determine a woman’s risk for developing invasive breast cancer. The Gail model, named for the physician who designed it, assesses a woman’s five-year and lifetime risk, based on her personal medical history. wakerad.com, and click on Breast Cancer Risk Calculator.

Wake Radiology serves the Triangle area with 14 convenient locations and 59 board-certified radi-ologists with imaging subspecialties available at each location. wakerad.com.

T H E N C C A N C E R H O S P I T A L

The state-of-the-art N.C. Cancer Hospital, clinical home of UNC Lineberger Comprehensive Cancer Center, is now open in Chapel Hill, N.C. Built on three decades

of excellence in patient care and groundbreaking cancer research at the University of North Carolina at Chapel Hill, and supported by a team of world-class physicians,

leading-edge technology, comprehensive patient support and innovative clinical trials, the N.C. Cancer Hospital offers new hope and possibilities for those facing cancer.

– Celebrate the strength and courage of those who fight cancer every day by sharing your story at unchealthcare.org –

Karla Werner, Cancer SurvivorPaul A. Godley, MD, PhD, Medical Oncology N.C. Cancer Hospital

MRI’s Role in Diagnosing and Targeting Treatment of Breast Cancer SuBmitted By Wake Radiology