MRI Breast Cancer Screening Overused for Low-Risk Women

Magnetic resonance imaging screening is not consistent with guidelines for women at low to moderate risk for breast cancer.

Breast screening with MR imaging is frequently performed but unnecessary among women with low or average risk of breast cancer, according to a study published in the Journal of General Internal Medicine.

Researchers from New Mexico, Massachusetts, Pennsylvania, Washington, New Hampshire, North Carolina, and California, performed a prospective cohort study to determine how often MR imaging was used for breast cancer screening among women who do and do not meet professional society guidelines for supplemental screening.

A total of 348,955 women received a screening mammogram as part of the
Breast Cancer Surveillance Consortium (BCSC); 1,499 underwent screening MRI. The researchers found that among women with less than 20 percent lifetime risk for developing breast cancer, which does not meet professional guidelines for supplementary MRI screening, and who had no first-degree breast cancer family history, screening MRI utilization was elevated among those with extremely dense breasts relative to those with scattered fibroglandular densities. It was also increased among women with atypia or lobular carcinoma in situ relative to women with non-proliferative disease. Approximately 82.9 percent of screening MRIs occurred among women who did not meet professional guidelines and 35.5 percent among women considered at low-to-average breast cancer risk.

The researchers concluded that use of breast cancer screening MR imaging
was not consistent with current professional guidelines and the goal of delivery of high-value care.