For some breast cancer survivors, fear and anxiety about the potential recurrence of cancer can take a significant toll on their emotional and physical wellbeing. At the MemorialCare Breast Center at Orange Coast Medical Center, we believe self-advocacy is an integral component of care for breast cancer survivors – and encourage and empower our patients to advocate for themselves throughout the process. Your diagnostic imaging team and oncologists welcome this partnership.
At Orange Coast Medical Center, we recommend that if you are a breast cancer survivor being monitored by imaging surveillance, you ask your oncologist whether magnetic resonance imaging (MRI) paired with mammograms would be beneficial to monitoring your treatment.
An MRI paired with mammography enhances the image of traditional mammography, allowing the breast radiologists, such as myself, to have an even clearer view of the breast structure. Because the use of MRI for breast cancer surveillance goes above and beyond the established national guidelines, we are setting an example for proactive care among breast cancer survivors, their oncologists and primary care physicians.
What are MRIs used for?
An MRI is typically used in the following ways for breast cancer screening:
- Screening patients who have never had breast cancer but are at an increased risk.
- Initial staging to determine the size of tumors and in re-staging to evaluate response to treatment like chemotherapy.
- Monitoring surveillance in patients who have been fully treated with breast cancer.
For more than 15 years, Dr. Jane Kakkis, medical director breast surgery, MemorialCare Breast Center at Orange Coast Medical Center, and I have recommended breast MRI testing as part of surveillance imaging for those in these risk categories:
- Those who have an advanced stage diagnosis and have an increased risk for recurrence. The degree of tumor and involvement dictates the risk of local recurrence
- Patients who have certain biological aspects to their tumor with a higher recurrence rate, even if treated totally
- Patients with certain genetic mutations like the BRCA1 or BRCA2, CHEK2 and PALB2 mutations have a higher risk of breast cancer in the other breast during their lifetime and should receive an MRI every year
- If a patient has had cancer and a mastectomy on the cancer side of the chest, prophylactic mastectomy on the other side of the chest and treatment on the cancer side of the chest, then MRI is used in two different areas. If the patient has had implant reconstruction, the FDA recommends surveillance with ultrasound or MRI every two to three years to check the implant status
- Patients who had very dense breast tissue before their breast treatments are often recommended to schedule an MRI test as part of their post-treatment surveillance because they are at higher risk for breast cancer in general
If you are a breast cancer survivor and would like to have the peace of mind that comes with having an MRI test, please consult with your physician to discuss how an MRI test may be of benefit.