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High Risk Women Underutilizing Breast MRI

Fewer than 7% of women eligible for supplemental screening breast MRI due to their assessed risk of breast cancer took advantage of the scan when offered, according to a new study published in the June issue of the Journal of Women’s Health.

The study team was led by Dr. Randy Miles of Massachusetts General Hospital, who said that “While nearly half of high-risk women attended a facility for screening mammography that also offered onsite breast MRI screening … actual use of onsite supplemental MRI was low. Only 6.6% of patients at high lifetime risk underwent screening breast MRI in our study.”

Supplemental breast MRI screenings are severely underused among women with a high risk of breast cancer, though the reasoning is unclear. A possible factor noted by Miles and his colleagues has been the availability of the technology. “High risk” women are defined by having more than 20% lifetime risk based on the U.S. National Cancer Institute’s risk assessment tool. The study team sought to determine whether patient characteristics influence supplemental breast MRI screening use, as well as investigate the availability of MRI screening for women at a high risk of breast cancer.

Illustration of a breast MRI procedure

The data was gathered from six Breast Cancer Surveillance Consortium (BCSC) registries for 422,406 women who had undergone routine mammography screenings in 2012. Sociodemographic data associated with the use of onsite breast MRI screening was also tracked.

1.3% (5,468) of the 422,406 women included in the study were at high lifetime risk of breast cancer. Of those of high risk, 43.9% (2,403) were presented with available onsite breast MRI screening at a BCSC facility, though only 6.6% (158) of the women actually underwent screening breast MRI within two years of their screening mammogram, Miles and colleagues wrote.

Particular patient characteristics were associated with breast MRI screening use as found by researchers (odds ratio higher than 1 associated with increased odds).

Odd ratios associated with higher use of breast MRI screening:

Younger than 40 years of age: 2.39

Some college education: 2.22

Prior breast biopsy: 2.09

Family history of breast cancer: 1.73

If the women had to travel an hour or more in order to get a breast MRI, they were less likely to undergo the exam (37.7%), contrasted with women that only had 15 to 30 minutes of travel time (49.7%).

According to the researchers of the study, more research is needed as to why women with a high risk of breast cancer aren’t taking advantage of supplemental breast MRI screenings.

Miles and colleagues concluded the following: “Nearly one-half of the high-risk women attended a facility offering onsite screening breast MRI. However, despite its widespread availability, use of the technology remains low among women classified as having high lifetime risk. A better understanding of the sociodemographic determinants of breast MRI underuse is needed to guide novel interventions that target high-risk women who may benefit from supplemental screening.”

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