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Evaluating Breast Cancer Screening: MRI vs. Mammography - A Critical Perspective


Question
Well yes we agree on the biopsy.. I don't think I agree with you with regard to the use of the Mamography.  MRI need to be improved so that Mamography can be shelved.  It is just old technology that needs to find its way to the trash bin.  It may not seem cost effective at first but in the long run it will save lives ANd eventually save dollars.  I'm sure we will disagree on that.  In my opinion women can be hurt as well as helped by outdated mamography and its time is passed.  But thank you very much on the imput on the biopsy issue..  
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Thanks very much for your input.. and I am coming to the same mind regarding the needle biopsy.  I have a meeting with the surgeon next week and will insist on a needle biopsy to be on the safe side - if he doesn't himself suggest one.  If this is cancer this is a true example of how identifying an individual as "high risk" can be most helpful for early detection - as I said before all of my mammography had been clear. Don't know if I mentioned age before - I am 51.  Also and this is for the readers.. Don't be fooled - I had checked with my fathers doc's when he died and was assured that there was no increase in risk when a male member of the family developed breast cancer  - that was 5 years ago but they now know that there definitely IS a risk connection.  If you have a male member of the family that has breast cancer it is just as dangerous (if not more so) as if a female member of the family has breast cancer.  So check with a genetic counselor and see if you should have a BRCA1/2 test and not just the girls in the family!
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Recently tagged "high risk" through genetic testing primarily because of father who died of breast cancer.  I am awaiting BRCA1/2 results and was advised to immediately do CA 125 (came back 15) and an MRI Breast and here in lies the problem.. it came with a small lesion an the left breast that the radiologist wants to go into with a needle biopsy.  The Surgeon however thought that was too quick a jump and ran a diagnostic bilateral digital with ultra (if necessary) it came back clean and the surgeon want to see  me to determine if a biopsy should be done.  I guess my question is this.  With the sensitivity of the MRI how is this decision made - is it now a judgement call and the expertise of the surgeon?  And should I trust that or insist on the needle biopsy?  Dad was on Tamoxifin for 10 years and then they told him he would have to get off with the new 5 year rules.. the cancer reoccurred almost immediately and he died the following year.  I do know that if this is cancer it would be caught at a very early stage and for that I am very thankful.  But this is certainly confusing.  It appears to me that no one should be doing mamo's anymore (I know I know the expense of MRI's) but the pain of a mamo and not to mention the exposure to radiation make it a test of the past IMO.  We need to improve MRI to be able to read the calcifications that it now misses, train the tech on the equip and in the long run there would be fewer MRI's so fewer $' spent.. maybe not right away.. but Rome wasn't build in a day.. Mammography is outdated technology if I can have cancer after having a clean mammogram, ultrasound and the MRI can find a lesion then the old x-ray has seen its day...  food for thought!
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Mammography is not out of date - in spite of radiation hazard that is a reality! - but should if possible be complemented with MRI & ultrasound scans. In your case you should INSIST on the needle biopsy soonest to be on the safe side! Good luck!

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So we do agree, good! You are right. Good luck!


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X-ray mamography - in spite of its radiation exposure risks -
can not be phased out until there is another method available with the same capabilities. The available possibilities are governed by the rules of physics and the level of our technology, so that will probably take a considerable time. In the meantime we will have to rely on what we do have, but using every possible technical method toreduce radiation exposure. Right?