Is Breast MRI Being Underutilized?

Breast MRI has been used for years, and has been found to have many benefits compared to Mammography. If this is true, then why is it still only prescribed for women considered high risk?

Most women who develop breast cancer are of “average risk”. Breast MRI improves early diagnosis of breast cancer compared to Mammography. Why not detect a potentially aggressive form of breast cancer earlier and improve chance of survival, and severity of treatment?

A study done at the University of Aachen, Germany, headed by Dr. Christiane Kul, confirmed these findings. From 2005 to 2013 they studied breast MRI impact on 2,120 women, ages 40 to 70. These women had less than a 15% chance of developing breast cancer in their lifetime. All these women had normal screening mammograms and, in the case of dense breast tissue, normal ultrasound screenings. Breast MRI detected 60 additional breast cancers, 40 considered invasive.

Of the 60 cancers detected over the observation period (7,007 screening rounds), 59 were only found using MRI. One was also found by mammography, none by mammography or ultrasound alone!

What does this tell us?shutterstock_604494149

MRI could serve as a beneficial supplemental screening tool for women of average risk, not just high risk. Also shows how beneficial MRI is in detecting the aggressive cancers earlier than Mammography.

Kuhl said, “After a negative MR imaging screening study, on average the first diagnosis of breast cancer is three years later. This suggest that the protective shadow of MR imaging screening, [i.e.,] a screening interval that results in low risk of an interval cancer in most women, may last longer than values observed for mammographic screening.”

Another study published April 13th in the “Journal of Surgical Oncology” found that Breast MRI vs Mammography and ultrasound more accurately imaged for tumor size with breast MRI. They deemed tumor size on imaging nonconcordant if it differed from the pathologic size by 33% or more. Tumor foci was deemed nonconcordant if more than one foci were seen in the tab. If one or both of the mammography or ultrasound was nonconcordant and the MRI was, they considered the MRI as having the greater accuracy.

What is Hindering Breast MRI?

The studies are proving that breast MRI shows many advantages, and not just to women deemed “high risk”. Then why is it still not being used on a regular basis? As everything it all comes down to cost. Though the study suggested considering the cost-benefit analysis. Providers should consider the low interval cancer rate of screening breast MRI, as well as possible further savings due to catching invasive cancers earlier.

Breast MRI may also reduce recall rates, as well as abbreviated MRI protocols could reduce the exam’s cost. Facilities and providers are highly encouraged to do a cost benefit analysis, also remember who your number one priority is, the patient! Greater patient care should always be the number one goal.

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