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Dean Park is a Harvard grad and a hematologist/onchologist at the South Bend Clinic. He grew up in the Washington D.C. area and did his medical training at the University of Virginia, the University of Chicago and Vanderbuilt University. He moved to Michiana with his wonderful wife, a professor at Notre Dame, and their one-year old son, who is just "rediculously cute".

What is MRI?

Magnetic resonance imaging (MRI) is really just another way of taking pictures of the human body. Instead of the x-ray radiation that is used for plain x-rays and computed tomography (CT, or CAT) scans, MRI uses powerful magnets and radio waves. The magnets are often in a tube-shaped machine, and lying in that tube for many minutes can be difficult for some people who are claustrophobic but there are some "open MRI" facilities which don't have the same structure. The strong magnetic fields can affect pacemakers, so patients who have pacemaker or other similar device are not able to get an MRI. Overall, though, MRI is very safe and does not have any known side effects.

Is breast MRI the same thing as a mammogram?

Not exactly. Breast MRI and mammogram are both tests that doctors use to examine the breast and look for abnormal areas. When abnormal areas are identified and suspicious for cancer, the MRI or the mammogram helps us biopsy (a fancy medical word for "take a sample of") the right spot. However, the MRI uses magnets and mammograms use x-rays. As a result, the pictures look quite different.

Is breast MRI better than mammogram at finding breast cancer?

This is a tricky question to answer! It depends in part on how we define "better." It is true that breast MRI can pick up some cancers that are missed by mammogram; however, it is also true that mammograms can find some cancers that are missed on MRI. So when breast MRI is done, it should used in addition to mammogram, rather than replacing mammograms.

Should everyone get a breast MRI in addition to their mammogram?

No. Although the images from breast MRI do pick up more cancers than mammogram alone, the MRI pictures also show other abnormalities that turn out to be benign (not cancerous). For the majority of women, this leads to unnecessary testing, expense, and anxiety.

Who should be getting a breast MRI in addition to mammogram?

For certain patients who are already known to have breast cancer, MRI can aid in treatment decisions, but this should be discussed on an individual basis. Women who do not already have breast cancer or any symptoms suggestive of breast cancer, may be considered for screening. The American Cancer Society (www.cancer.org) currently recommends the use of breast MRI for screening purposes in women who have a greater than 20% lifetime risk of developing breast cancer.

Do I fall into the "20% lifetime risk" category?

Again, this is a question that should be addressed on an individual basis with your doctor. In general, here are some of the groups of women who would be considered at higher risk:

Women who are known to carry a genetic mutation that predisposes to breast cancer, or if that mutation exists in close family members
Women with multiple family members with breast and/or ovarian cancer, especially if they are of Ashkenazi Jewish ancestry
Women who received radiation therapy to the chest area at a young age (for example, as part of treatment for Hodgkin disease)

As is always the case when new technologies and methods are introduced into the medical field, these guidelines and recommendations may change over time as more data and experience emerge. The best approach is to always keep an ear out for new developments and ask your physician about what's best for you!

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