Breast MRI Screening: Considering the Harms and Benefits
Researchers of a study found that using magnetic resonance imaging (MRI) in women with a prior breast cancer history found more cancers vs mammography, but there were considerably more biopsies. Although the cancer detection rate was greater for breast MRI vs just mammography, the breast MRI biopsy rate was greater than two-fold higher (10.1% vs 4.0%). The researchers of this study say that the possible benefits and harms of breast MRI, particularly the impact of increased biopsies, should be considered when including it into surveillance imaging approaches.
They also note that there are a lack of national recommendations when it comes to suggesting breast MRI for regular surveillance in patients with a personal breast cancer history. While the evidence is limited on the benefits and harms of this population, the American College of Radiology suggests yearly breast MRIs for patients with dense breasts who were initially diagnosed with breast cancer when they were younger than the age of 50. In the study, no considerable difference was found in the sensitivity between mammography vs breast MRI in detecting breast cancer or interval cancer rates.
The researchers note that it is imperative for when policymakers are considering new surveillance strategies, to look at how comparisons are made, and realize that while it may be the right option for some women to receive breast MRI, there must also be considerations for how frequently mammography should be used in locating second breast cancers. Surveillance intervals may need to be shortened compared with the current recommendation to receive a mammogram yearly after a breast cancer diagnosis, instead of adding more tests.
Bassett, M. MRI Screening Finds More Breast Cancers, but at What Cost? MedPage Today. Published July 24, 2019. Accessed September 22, 2022. https://www.medpagetoday.com/hematologyoncology/breastcancer/81189