MRI vs. Mastectomy how to decide by; Dr S. Narod

• a quote from Dr. Narod, “if only exercise was a onetime thing, but unfortunately you can’t just do it for a month and be good for 50yrs”


• Something to think about… MRI is not available for pregnant women, as well as some of the other non surgical screening options are not available (ultrasound, tamoxifen, MRI, mammography, chemotherapy before 5 months, etc.). Mastectomy is available 24/7 so to speak.


PRO's of Mastectomy

• Lowest risk of cancer possible

• One time intervention

• No follow-up necessary

• Reconstruction options available

• No concern with hormone replacement therapy (HRT) • Major surgery (surgical complications)


CON's of Mastectomy
• Residual risk of 2-3%

• Body image changes

• Loss of nipple and breast sensation

• Breastfeeding not optional


 PRO's of MRI

• High sensitivity- finds them early and small

• Reduces risk of advanced breast cancers

• No major surgery

• Good survival potential thus far


CON"S of MRI

• Doesn’t prevent cancer

• (Dr. Narods opinion) small cancers found should be treated with chemotherapy

• Not yet shown to reduce mortality

• Better combined with tamoxifen (induces a menopause like syndrome)

• No guarantees of cure

• Claustrophobia

• Weight restriction on machines

• Annual examination (40yrs of Dr visits)

• Dependence on that annual visit


Oophrectomy removal of ovaries

 Prophylactic salpingo-oophrectomy (PSO) removal of ovaries and fallopian tubes at age 35 in recommended highly, best survival rates and morbidity is reduced

• Age 35 for BRCA 1 and 40 for BRCA 2

• Mastectomy of both breasts ensures that there will be no return of a second cancer to the opposite side, high occurrence of cancer return to the other side. The greatest significance of the results from both surgeries are seen after 20yrs after, not much difference seen in first ten years

• So if you plan to live for 20yrs or more Dr. Narod was strongly suggesting that both procedures be done in the recommended time