There is some debate over the usefulness of preventative screening in patients who show no sign of sickness. However, as technology advances, many medical professionals are encouraging high risk patients to consider receiving a scan, as it could save their life.
An asymptomatic individual is a person who has the presence of a condition, but they are showing no symptoms. Some asymptomatic diseases when left untreated will progress into more life-threatening conditions, such as stroke, heart attack, aneurysm rupture, or metastatic cancer.
Examples of asymptomatic conditions that can escalate slowly or quickly are aneurysms in the chest, aorta, or brain vessels, tumor and malignancies in the kidneys and liver, and cysts in the ovaries. When a high-risk patient decides to receive a preventative screen, it allows their doctor to detect these life-threating conditions in an early stage and treat the condition before it worsens.
Why use MRI Over Other Modalities?
In the past, doctors typically used CT scans for preventative whole body screening. However, it is no longer thought of as a viable tool for most patients. This is because of the ionizing radiation that occurs during a CT scan, which is a risk factor for cancer.
For today’s preventative screenings, most doctors recommend choosing MRI. Many patients benefit from early cancer detection, which can be accomplished with MR, without the danger of ionizing radiation.
Furthermore, MRI image quality is so advanced that it has the ability to clearly define structures and lesions within the body in far greater detail than other modalities. Using the latest technology in MR, physicians can now create 3D reconstructions of targeted areas in the body, allowing them to determine if a lesion is benign or if it requires further investigation.
Many institutions are able to perform the whole body MR scan in about an hour, imaging the patient from their head to their knees. The speed, accuracy, and detail provided by this screen comes at no risk to the patient’s health.
Who Should Consider Preventative Screening?
Doctors do not recommend that everyone undergo whole body preventative screening. In fact, unless there are reasons to suspect a disease is present, most doctors recommend against having it done.
This is because in any person it is possible to find meaningless tissue abnormalities that do not indicate a genuine problem. If something unusual is found on a scan, it generally means the person will go forward with additional tests and interventions that can be more invasive and may be unnecessary.
However, if you are considered a high-risk patient, most doctors are very supportive of preventative screening.
A high-risk patient is someone who:
- has a history of neurological problems or family history of aneurysm
- family history of stroke or cancer
- any risk factor favoring early detection of cancer
- joint or extremity problems or unexplained pain
- unexplained weight loss, malaise, fatigue
- previous history of cancer
Preventative Breast MRI Screening
Preventative breast screening is also often recommended due to the following events:
- an inconclusive mammogram and ultrasound
- a patient is experiencing breast or chest pain
- a patient has small dense breasts
- a patient has personal or familial history with breast cancer
At this time, when it comes to preventative breast screening, mammography remains the only clinically proven imaging modality to reduce mortality from breast cancer. However, while screening mammography has improved the detection of breast cancer, it has several limitations.
Specifically, in screening young women, women with dense breasts, and in women with the BRCA gene where mammography sensitivity can be lower. Research shows that breast cancer still occurs in 10% to 35% of women despite adequate mammogram screening.
MRI preventative screening for women has proven very clinically valuable. These procedures find about 12% more malignancies than traditional screening methods. Furthermore, a high percentage of these findings are detected when the cancer is still considered to be at an early stage.
Multiple studies have evaluated breast MRI screening in high risk patients, and found that the sensitivity of MRI for detecting lesions exceeds mammography 75% to 32% respectively.1
While preventative screening is not recommended for everyone, successfully detecting and identifying lesions, cysts, and tumors in their early stages could be the difference in life or death for many patients.
Not only are these measures beneficial to patient’s health, but in the long term early detection and treatment tends to save patients money, especially considering preventative health services are now covered by Medicare and private insurance companies.
For those labeled as high-risk, considering preventative whole body MRI screening over other modalities could help you feel more confident in your health and your future.
Current Controversies Surrounding MRI Screening for Breast Cancer. Physicians' Education Resources. https://www.gotoper.com/publications/ajho/2015/2015aug/current-controversies-surrounding-mri-screening-for-breast-cancer (Accessed July 3, 2018)