Story Photos
 Dr. Mario Forte, left, and Kelly DeRoiser, breast care coordinator for the Columbia Regional Breast Center, show off new equipment that lets St. John Medical Center perform MRI breast scans and biopsies. Bill Wagner / The Daily News
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MRI upgrade expands St. John breast cancer treatment
Wednesday, November 19, 2008 1:49 PM PST
By Barbara LaBoe
Printable version
E-mail this articleSt. John Medical Center officials say a new breast MRI service allows doctors to better treat difficult breast cancer cases that otherwise would be sent out of town.
MRI breast scans aren’t for everyone, not even for every woman with breast cancer. But for women with particularly dense breast tissue, for instance, they’re a valuable tool that gives doctors more information, said Dr. Christine Katterhagen.
“This is an additional tool, it does not replace mammography,” Katterhagen said. “It’s a different way of looking at things.”
St. John was able to add breast MRI imaging by purchasing additional equipment for its MRI machine and by upgrading the overall MRI magnet, said Kirk Raboin, St. John’s imaging services director. The cost was $400,000 and the higher grade magnet benefits all MRI scans, Raboin said.
“This puts more tools in our tool chest,” Raboin said. “This isn’t a front-line screening tool, but it is an augmentation that in the right clinician hands can better differentiate breast lesions.”
Ironically, the scans can be most useful in proving something isn’t in the breast tissue, Katterhagen said.
“There are a fair amount of false positives,” which is why MRI is not the primary screening tool, she said. “But when an MRI is negative, it’s truly negative.”
Doctors can use the test to “clear” a patient’s other breast to be sure it also doesn’t have cancer. And, it can allow a patient to chose a lumpectomy and save their breast with a greater degree of confidence that all of the tumor has been removed.
Dr. Mario Forte said in recent weeks he’s had one patient who was able to conserve her breast because an MRI scan found no other cancer in the tissue. In another patient, the MRI scan identified another tumor that hadn’t been detected with other equipment.
Magnetic resonance imaging machines use a large magnet and radio-frequency waves to produce high quality images of the body’s organs, blood vessels and other body parts. Unlike X-rays, radiation isn’t involved. Instead, the scan monitors energy changes in tissues as they react to the magnetic forces. A computer analyzes those changes and creates an image of the tissues and structures.
MRIs can help in breast scans because the scans are more sensitive to tissue differences, Raboin said.
The ability to use the MRI scans for precise biopsies also is a plus, Forte said. Biopsies remove a piece of a tumor with a large needle to test and see if it’s malignant. Doctors can use the scans in real time as they place and manipulate the needle.
The new equipment was installed this fall and doctors traveled to Seattle for training. So far about eight breast MRIs have been completed in Longview. The first MRI breast biopsy was done Oct. 13.
The breast MRIs are expensive — $2,200 a scan — and aren’t always covered by insurance. That’s part of the reason they’re not recommended for regular screening. Still, doctors said they like being able to offer the service here instead of sending patients who need them to Seattle or Portland for the scans.
“Before, patients would have a two hour drive ... and we weren’t standing right there next to the radiologist seeing the results,” Katterhagen said. “It’s good to have the ability to do this all under one roof.”
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