Supplemental MRI Screening for Breast Cancer Greatly Underutilized

Supplemental MR imaging for women at higher risk for breast cancer is not done frequently enough.

Supplemental breast MRI is widely underutilized among women who may benefit from earlier cancer detection, according to a study published in the Journal of Women’s Health.

Researchers from Massachusetts, Washington, New Hampshire, Colorado, North Carolina, and New Mexico performed a cross-sectional study of 422,406 women to assess the use of MR imaging screening in early cancer detection.

The women underwent routine mammography screening across 86 Breast Cancer Surveillance Consortium (BCSC) facilities during 2012. The researchers determined availability and use of on-site screening breast MR imaging services based on woman-level characteristics, including a higher than 20 percent lifetime absolute risk using the National Cancer Institute risk assessment tool. Multivariate analyses were performed to determine sociodemographic characteristics associated with on-site screening MRI use.

The results showed that overall, 43.9 percent (2403/5468) of women at high lifetime risk attended a facility with on-site breast MRI screening availability. However, only 6.6 percent (158/2403) of high-risk women obtained breast MRI screening within a two-year window of their screening mammogram. Patient factors associated with on-site MR imaging screening use included:

• Being younger than 40 years
• Family history
• Prior breast biopsy
• 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 MR imaging availability, supplemental breast MR imaging was widely underutilized among those who may benefit from earlier cancer detection. They encourage 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 MR imaging.

"Breast MRI screening may benefit women with a high lifetime risk of breast cancer through earlier cancer detection," said Susan G. Kornstein, MD, in a release. "A greater understanding is needed of why this widely available resource is not being fully utilized to screen high-risk women." Kornstein is the editor-in-chief of Journal of Women's Health, executive director of the Virginia Commonwealth University Institute for Women's Health, Richmond, Va., and president of the Academy of Women's Health.