Do digital mammography and MRIs improve health outcomes?

Digital mammography and MRI have been offered as improvements over conventional mammography, but although they find more “stuff,” they don’t pass the important test of improving health outcomes. They don’t save any more lives, probably because of the biology of breast cancer tumors. Some tumors grow at a moderate rate; these are the cancers for which mammography appears to be most useful, allowing us to catch them before it is too late and treat them successfully.

But other tumors are very aggressive and invasive; unfortunately, finding these tumors early has a limited effect on our ability to treat them. Still others grow very slowly and don’t always turn into full-blown cancer. A tool that finds more of the faster slow-growing cancers may not have a big impact on survival rates, but it will definitely make its owners a lot of money.

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