Supplemental Breast MRI Widely Underutilized in High-Risk Women

July 2, 2018

Further study may determine if patient awareness can mitigate the underutilization of supplemental screening breast MRI.

Nearly half of women who have a high lifetime breast cancer risk undergo routine screening mammography, yet supplemental breast MR imaging remains widely underutilized in this group, according to a study published in the Journal of Women’s Health.

The researchers obtained data of 422,406 women who underwent routine mammography screening across 86 Breast Cancer Surveillance Consortium (BCSC) facilities in 2012. They determined availability and use of on-site screening breast MRI services based on woman-level characteristics, including a higher than 20 percent lifetime absolute risk using the National Cancer Institute risk assessment tool.

The results showed that 2,403 of 5,468 women (43.9 percent) who had a high lifetime risk attended a facility with on-site breast MRI screening availability. However, only 6.6 percent (158/2,403) of high-risk women obtained breast MRI screening within a two-year window of their screening mammogram.

The patient factors associated with on-site MRI screening use included being younger than 40 years of age, having a family history of breast cancer, having a prior breast biopsy, and postsecondary education.

The researchers concluded that while nearly half of women at high lifetime breast cancer risk undergo routine screening mammography at a facility with on-site breast MRI availability, supplemental breast MRI remains widely underutilized among those who may benefit from earlier cancer detection. They recommended that future studies evaluate whether other enabling factors such as formal risk assessment and patient awareness of high lifetime breast cancer risk can mitigate the underutilization of supplemental screening breast MRI.