Breast MRI is not a first-line breast cancer screening tool for most women. The American Cancer Society recommends annual MRI screening only for women with a lifetime risk of breast cancer that’s greater than 20-25 percent, and only as an adjunct to mammography. The problem is that MR images are too clear, leading to too many false positives, the ACS explains.
“While the high rate of biopsies and further investigations is acceptable in women with a high risk of breast cancer, the number of such investigations in women at lower risk will be much higher than would be appropriate, leading to the need to counsel women in lower risk categories that MRI screening is not advisable and that the harms are believed to outweigh the benefits,” wrote researchers for the American Cancer Society Breast Cancer Advisory Group in the ACS guidelines in 2007.
However, a study published in the May 2017 issue of the journal Radiology suggests that it could be time to rethink these recommendations. Researchers from the University of Aachen studied 2120 women, aged 40 to 70, with lifetime breast cancer risk factors of less than 15 percent. The women received screening via MRI, ultrasound, and mammography between 2005 and 2013.
Of the 60 cancers discovered in the study, 59 were observed using MRI scans. None were uncovered by ultrasound or mammography alone. Meanwhile, the positive predictive value of the MRI screening was high, hinting that concerns over false positives may be exaggerated given current MR technology and advances in radiology practice.
“In women at average risk for breast cancer, MR imaging screening improves early diagnosis of prognostically relevant breast cancer,” the authors concluded.
Other Factors Limiting the Use of Breast MRI Screening
Even if further studies show that false positives are no longer as prevalent in MRI breast screening as they once were, other barriers continue to limit patient access to the procedure.
There are two major reasons physicians don’t order more breast screening via MRI, reports Radiology Today magazine: Insurance companies won’t cover breast MRI for women unless they show high risk, citing excessive costs for the procedure; and there simply aren’t enough MRI providers across the nation.
These are concerns that patients and physicians in many parts of California, Nevada, and Arizona needn’t worry about. Precise Imaging operates a growing network of more than 70 free-standing imaging centers in communities across these states — with more on the way.
Precise Imaging Expands Access to Breast MRI Scans
By providing access to MRI scans within many communities, Precise Imaging allows patients to schedule appointments when and where they please. This greatly expands the total MRI capacity in areas where Precise Imaging operates.
As for the issue of cost, Precise Imaging provides a streamlined, flexible billing system, allowing patients to pay through as many avenues as possible. That includes Medicaid/Medicare, PPO insurance, personal injury liens, letters of protection, and low cash prices.
And because Precise Imaging providers aren’t attached to a broader hospital system, they don’t have to balloon prices to cover high-loss areas, such as emergency services. Together, these factors allow Precise Imaging to offer more diagnostic imaging procedures — including breast MRI — to more patients at a lower cost.
Some day soon, breast MRI might becomes a standard screening procedure for all women, with life-saving results.
Kanal K, Butler P, Sengupta D, Bhargavan-Chatfield M, Coombs L, Morin R. U.S. Diagnostic Reference Levels and Achievable Doses for 10 Adult CT Examinations. Radiology. 2017 284:1, 120-133. doi:10.1148/radiol.2017161911
Saslow D, Boetes C, Burke W, et al. for the American Cancer Society Breast Cancer Advisory Group. American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography. CA: A Cancer Journal for Clinicians. 2007 57: 75–89. doi:10.3322/canjclin.57.2.75
Yeager, D. MRI Monitor: Brevity is the Soul of It. Radiology Today. 2017 18:10, 28. http://www.radiologytoday.net/archive/rt1017p28.shtml