Breast Cancer: Does Cost Prevent Better Prevention?



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Breast cancer: does fear of costs prevent better prevention? Doctors from the University Clinic in Bonn found in a study that magnetic resonance imaging (MRI) is superior to mammography or ultrasound in the detection of breast cancer.

Doctors from the University Clinic in Bonn found in a study that magnetic resonance imaging (MRI) is superior to mammography or ultrasound in the detection of breast cancer. The team around Professor Dr. Christiane Kuhl from the University Hospital Bonn examined almost 700 patients over five years (2002-2007) with ultrasound, mammography and MRI (magnetic resonance tomography) and has now published the results in the journal "Journal of Cilnical Oncology" (doi: 10.1200 / JCO . 2009, 23.0839). Breast cancer or a preliminary stage of breast cancer ("DCIS", Ductales Carcinoma In Situ) was diagnosed in 27 of the participating patients. In their multi-center study, they found that only 33 and 37 percent of breast tumors were detected by mammography and ultrasound, respectively, while 93 percent could be detected by magnetic resonance imaging.

Another advantage of the MRI is that the women are not exposed to any radiation. It is also being discussed whether the constant radiation caused by previous investigations could have an influence on the formation and development of the tumor and genetically predisposed women. Because mammography is an examination with X-rays, while MRI is a magnetic field stimulated from outside with radio waves. One disadvantage seems to be the cost factor: the MRI costs around 450 euros per examination. A mammography costs just 110 euros.

The researchers advocate that the MRI should not only be used in conjunction with the breast examinations, but in a standardized manner, and that the guidelines should therefore be changed. They only recommend an MRI in addition to ultrasound or mammography for women in “high-risk levels”.

The Bonn scientists point out that the mammary gland tissue of young women is significantly more sensitive to radiation and the “radiation biological consequences” cannot be foreseen in the examinations recommended by the current guideline.

Ultrasound also appears to be unnecessary as a preventive measure, as it did not reveal any additional carcinomas in the study. Now it remains to be seen how the decision-makers will behave in the implementation of the quality and payment of breast cancer preventive examinations based on the results of the Bonn doctors. (Thorsten Fischer, naturopath osteopathy, 02/26/2010)

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