How MRI Scans Find Breast Cancers Like Christina Applegate's
When I first heard that actress Christina Applegate had breast cancer, I wondered how the 36-year-old's tumor was detected. Did she find the lump herself, or did her doctor feel it during a regular checkup? Perhaps Applegate was diagnosed via a screening mammogram, like my 37-year-old friend, Panina. Turns out, Applegate's tumor was detected through magnetic resonance imaging, which was ordered by her doctor, according to her publicist. That decision could prove lifesaving because the cancer was caught early—when it's most likely to be cured.
The exquisitely sensitive MRI is very good at detecting tumors in young women whose dense breast tissue often hides tumors on mammogram X-rays. But it's very expensive and all-too-frequently detects false abnormalities that necessitate biopsies. For this reason, the test is recommended only for those at increased risk of breast cancer. (Breast cancer is very uncommon in those under 50, so it would be foolhardy to screen all women in their 30s.) News reports disclosed that Applegate's mother had previously battled breast cancer, but that by itself isn't usually enough to justify an MRI in a woman so young. Last year, the American Cancer Society issued recommendations for the use of MRI screening for women at increased risk of breast cancer, as my colleague Katherine Hobson previously reported. You should have an annual test if you fall into one of these categories:
1. You have a BRCA1 or BRCA2 gene mutation.
2. Your mother, sister, or daughter has a gene mutation, and you haven't been tested.
3. You have a lifetime risk of breast cancer of at least 20 percent using this widely accepted risk assessment tool.
4. You received radiation treatment to the chest between ages 10 and 30 for conditions such as Hodgkin's disease.
5. You carry or have a first-degree relative (parent, sibling, child) who carries a genetic mutation in the TP53 or PTEN genes responsible for these conditions: Li-Fraumeni syndrome; Cowden syndrome; Bannayan-Riley-Ruvalcaba syndrome.
Other women who have a personal history of breast cancer or precancers or who have extremely dense breasts, says the ACS, could also benefit from screening MRIs and should talk to their doctor about whether they should get screening.
Tags: breast cancer | medical screening | women's health
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Reader Comments
Well-done
As a medical student I am always concerned when I read articles from the lay-press on medical issues. I find that they so often misinterpret the literature on important subjects leading to either too much or too little concern on behalf of readers. This brief piece strikes the perfect tone and utilizes a credible source of evidence, all the while remaining readily understandable. I had never read your work before, but I will make sure to check back more often.
Regards
Breast cancer in young women
Next to accidental death and homicide, breast cancer is the leading cause of death in women of childbearing age. Younger women with breast cancer are more likely to die from their disease compared to older women.
Younger women are more commonly diagnosed with advanced disease compared to older women. For example, one out of every three women less than 40 years old will have positive lymph nodes at the time of diagnosis compared to only one out of every ten women greater than 70 years of age at diagnosis.
Younger women are more likely to be diagnosed with more aggressive tumor types.
Breast cancer treatment often has a greater impact on the quality of life of younger women. For example
* younger women are more likely to receive chemotherapy than older women
* younger women often have children in the house to care for during treatment
* infertility can result secondary to chemotherapy
* sexual dysfunction secondary to chemotherapy is more common in younger women
* depression occurs more frequently in younger women with breast cancer, than in older women
* younger women worry about what will happen to their children if they don't survive
There are many questions left unanswered in the treatment of breast cancer in younger women. For example, we do not really know how much chemotherapy for breast cancer impacts fertility. In fact, there is very little data on whether or not if it is even safe to get pregnant after being diagnosed with breast cancer. Given the fact that tens of thousands of women of reproductive age are diagnosed with breast cancer each year and that women are increasingly postponing childbearing, finding answers to these questions and raising the awareness of younger women and physicians about breast cancer in younger women should be a national priority.
www.breastcure.com
breast cancer age of onset
actually, breast cancer in women under the age of 50 is not at all uncommon.....i am a survivor and was diagnosed under that age, as were many women i know. My doctors treat many women from late 30s upward...
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