Questions, answers on MRIs and breast health

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(AP) -- The American Cancer Society is recommending MRIs in addition to mammograms for certain women considered to be at unusually high risk for breast cancer. Here are more details:

Question: Who should get an MRI?

Answer: Those with a mutation in the BRCA1 or BRCA2 genes; those who were treated for Hodgkin's disease; those with a strong family history of the disease, such as women with two or more close relatives who had breast or ovarian cancer or who have a close relative who developed breast cancer before age 50. Experts say about 1 in 50 adult U.S. women fall into this category.

Also, a new study suggests MRI is useful for women who have cancer in one breast. MRIs turned up tumors in the second breast that other techniques had missed.

Q: Why is an MRI necessary?

A: MRIs are better at showing increased or abnormal blood flow in the breast, a sign of early cancers not visible on mammogram. They also are better than mammograms at detecting cancer in women with dense, non-fatty breasts.

Q: Why do I still need to get a mammogram then?

A: Mammography is considered a very good diagnostic technique, and it can show things MRIs miss, like calcium deposits, which are usually benign but which can occur in patterns that indicate breast cancer.

Q: What are the downsides of MRI?

A: They make mistakes -- one estimate is 5 percent to 25 percent of MRI positive tests are wrong. That can lead to unnecessary biopsies and mental anguish. And they are expensive, costing $1,000 to $2,000. Not all insurers will pay for them.

Also, the test can take an hour or more and requires lying in a tunnel-like scanner.

Q: How do I choose an MRI testing facility?

A: Some medical facilities that offer MRI lack the expertise and equipment to do MRI-guided biopsies, meaning the MRI will have to be repeated elsewhere if a positive result is found. The cancer society says breast MRIs should be done at places that do biopsies as well.