Comparing and Contrasting Articles: Trade Article vs.

Medical Journal
Ashley Coffey
Trade Article: MRI for Breast Cancer Detection
Trade articles are broad articles about current topics happening within a certain realm of
interest. While they remain informal and written by paid staff, they cover topics that appeal to a
population and still inform the public in a professional manor. In a Radiology Today article
written by Dr. Kamilia Kozlowski,2 the use of MRI to detect breast cancer in high-risk woman is
focused on and discussed.
The trade article by Kozlowski discusses the trend of using MRI scans as a form of
detecting breast cancer in high-risk women. A certain population of women have factors that can
make standard mammogram cancer detection difficult or misleading; these factors include dense
breasts, breast implants, and previous radiation or surgeries of the breast. Ductal carcinoma in
situ (DCIS) can be difficult to detect early due to the nature of the disease but over the year, MRI
has proven a highly affect way of diagnosing DCIS. A study in Germany followed 7,000 women
and discovered that MRI could detect 92% of DCIS cancer and mammography only found 56%
of these cases.2 Aside from higher accuracy in detection, MRI can help provide a more accurate
size and spread of the disease. This is useful in decided the best treatment course.
Insurance companies fight that MRI is not necessary for breast cancer detection; they can
produce false positives due to their high sensitivity and are more expensive than the standard
mammogram. With this being said, the efficiency of MRI in breast cancer detection has come a
long way in terms of development. Dr. Kozlowski and other doctors worldwide are starting to be
favorable in including MRI as a normal form of detection in high-risk breast cancers.2

The discussion of MRI for detection is important to the physician, treatment team, and
patient. With a sharper image of the disease, the physician is able to better identify what needs to
be treated and this information is passed down to the dosimetrist. Thus, radiation treatments can
be more precisely planned from these MRI images. With earlier detection, the field of radiation
therapy can move away slightly from treating young woman with metastasis from breast cancer
to treating the primary cancer before it spreads.
I think the article did a great job of informing the public about the current trend in cancer
diagnosis. Dr. Kozlowski is the medical director at Knoxville Comprehensive Breast Center and
the president of the Aurora Breast MRI Society.2 She demonstrated knowledge and some
statistics to support her claim that seems credible. The article was clear and easy to follow while
citing sources throughout. However, due to her association with the Aurora Breast MRI Society,
the article can seem biased in favor of MRI diagnosis. She does not mention she is the president
of the society in the article but it is mentioned at the end. Even though she seems to provide
adequate reasoning on the benefits of MRI, she fails to discuss any possible downfalls or cons of
using MRI scans for breast cancer diagnosis.
Overall, I believe the article was concise, informative, and thought provoking to the way
diagnoses will be heading in the future. The terminology was simple and would appeal to the
layperson. Although there is very clearly a conflict of interest with the author and lack of
disadvantages to MRI scans, the argument could still be made to the benefits for high-risk
patients. The advantages of MRI were clearly stated and it seems to provide great advances in
discovering breast cancer while it is in the early stages.

References
1. Lenards N, Weege M. Readings and Writings in Radiation Therapy and Medical
Dosimetry. [Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Kozlowski K. (2008 October). Breast MRI: A Case for Wider Use. Radiology Today,
(9)20:20. Retrieved from http://www.radiologytoday.net/archive/rt_100608p20.shtml.

Medical Journal: Effectiveness of screening with annual magnetic resonance imaging and
mammography

Professional publications, such as medical journals and peer reviewed articles, are written
towards a specific audience with a very narrow topic. These articles usually contribute thorough
research and explore new methods and advancements in a field.1 The Journal of Clinical
Oncology has published an article covering the use of annual MRI scanning and mammography
to discover high risk breast cancers. The article took data from a study done by the Ontario
Breast Screening Program and analyzed the effectiveness of MRI and mammograms separately
and also the results.2
Initial breast cancer screenings were analyzed on 2,207 women who presented as highrisk candidates; this includes having BRCA 1 or BRCA 2, family history of hereditary breast
cancer or genetic mutation, or previous radiation therapy to the chest. Results were based off of
which modality picked up abnormal results. There is a mammography alone group that refers to
an abnormal finding on mammogram but not on MRI. Another group is the MRI alone group,
which is reversed: normal mammogram but abnormal MRI. The last group consisted of abnormal
findings on both mammogram and MRI results. If the patient refused an MRI, they were
excluded from the study. This ensures that MRI and mammogram results can accurately be
compared at the end of the study. Of the remaining 2,150 women in the study, 554 (25.85) of
them had abnormal results with 35 total breast cancers confirmed.2
In this study, MRI alone had 8.7% more abnormal detection than mammograms. There
also were more false recalls with MRI than with mammogram. However, mammogram detected
zero breast cancers while 23 were found with MRI alone, and 12 were found with both

mammogram and MRI. The sensitivity of MRI is known to be 71-100% sensitive while
mammograms are only 13-40% sensitive.2 This difference in the two modes of imaging is what
makes the detection of early stage breast cancer more likely. Recently, the American Cancer
Society and other guidelines have suggested annual MRI with or without mammograms to test
for high-risk cancer in women between the ages of 30 and 69 years of age.
There are many great advantages of this article; the scientific data clearly supports the
research at hand and is presented as numbers and facts. It makes it very clear to understand that
benefits are MRI versus mammogram detection. The results of this study were paralleled to other
studies results and found to be comparable in the percentage of detection by MRI; Six other
studies found results all within the same range of about 8.2 to 15.9 out of 1,000 MRI detections
in high-risk women.2 I did not find any downfalls or biases in this article in any way; the
research was professional and concise to the subject at hand. It is great to see positive results in
the aspect of detecting breast cancer earlier in high-risk women. Even with the heavily detailed
information, the results were well defined and that lives can be saved with a study as such.
One significant difference in the two articles is when it comes to the type of breast cancer
detected. The trade article by Dr. Kozlowski discussed the important of MRI scans to detect
DCIS more affectively.3 However, the medical journal by Chiarelli et al2 revealed in their study
that cancer detection was significantly higher for invasive cancers than it was for DCIS (27
versus 8). This demonstrates the difference between a trade article and medical journal
publication well. Trade articles may be appealing to the public but possibly misleading. The
scientific facts behind them are not always as accurate as they would be in a medical peer
reviewed journal. An appropriate medical journal will include statistics that will encompass any
data found, not just favorable results.

References
1. Lenards N, Weege M. Readings and Writings in Radiation Therapy and Medical
Dosimetry. [Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Chiarelli AM, Prummel MV, Muradali D, et al. Effectiveness of Screening with Annual
Magnetic Resonance Imaging and Mammography: Results of the Initial Screen From the
Ontario High Risk Breast Screening Program. J Clin Oncol. 2014; 32(21): 2224-2230.
http://dx.doi.org/10.1200/JCO.2013.52.8331
3. Kozlowski K. (2008 October). Breast MRI: A Case for Wider Use. Radiology Today,
(9)20:20. Retrieved from http://www.radiologytoday.net/archive/rt_100608p20.shtml.