Furthermore, fear of lawsuits among surgeons and radiologists also influences the decision to order these tests.
“So what can we do?” asked Dr. Bleicher. “Always do what’s best for the patient, [and] you need to document your rationale. MRI is indeed a valuable tool, but we really do need to define its indications both to justify the cost involved and to clarify when not performing it is true breach of duty to the patient.”
The panel concluded that there is a need to establish evidence-based criteria for ordering MRIs in different clinical scenarios. “The potential research applications of MRI should not be confused with routine clinical practice,” said Dr. Morrow.
“MRI is not emerging – it has fully emerged – and in some respects, the train has already left the station,” said Dr. Port. “I think what we need to do at this point is really re-establish definitive guidelines for [MRI] use in women with newly diagnosed breast cancer for whom there are no clear-cut guidelines and for whom practice patterns range widely.”
The panel members reported no relevant conflicts of interest.