Use of Breast MRI Increasing Among Women in the U.S.

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Based on two new studies, a growing number of American women are receiving breast magnetic resonance imaging (MRI) as a means to screen for cancer.

However, there are still some concerns that expensive MRIs are not being utilized among the numbers of women who would benefit the most from this imaging system.

"It's a great new test but no one had looked at how and if it was really used. These are the first studies to really document the use and rates of use for breast MRIs,” said assistant professor in the Department of Population Medicine at the Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston, and who led one of the studies, Natasha Stout.

“In addition to not exposing women to radiation MRIs are known to be more sensitive and show more small abnormalities than traditional mammograms. But that also means more false alarms that result in biopsies,” said chief of breast surgery at Duke University in Durham, North Carolina, co-wrote an editorial accompanying the new studies published this week in JAMA Internal Medicine, Dr. Shelley Hwang.

Both the American Cancer Society and the National Comprehensive Cancer Network suggested breast MRIs be employed in accordance with mammograms among women who present a lifetime breast cancer risk of 20% or higher, usually due to their family history.

Stout's team examined MRI tendencies at two healthcare systems in the northeastern U.S. from 2000 to 2011. The group acquired data from 10,518 women who were 20 years old and older and had at least one breast MRI.

Another group, led by Karen Wernli at Group Health Research Institute in Seattle, utilized data from five different U.S. breast cancer registries from 2005 to 2009. Their set of data featured information on 8,931 breast MRIs and about 1.3 million mammograms performed on women between 18 and 79 years old.

Both teams eventually found that breast MRIs have become more widespread.breast MRI

Stout and her team noted an increase from less than one breast MRI for every 1,000 women in 2000 to 10 breast MRIs per 1,000 women in 2011.

Wernli's team discovered the use of breast MRIs increased from about four per 1,000 women in 2005 to 12 per 1,000 women in 2009.

"The main motivation behind this study has been that while there has been an increased use of breast MRI, no one has been able to determine why there was an increase in breast MRI use," said Wernli.

What her group found was that around 40% of breast MRIs were being employed to help make a diagnosis following another test or observation. About 32% were used for screening.

Wernli's team also found the quantity of MRI-screened women who met the cutoff for a high risk of breast cancer increased during the study. yet, only 5% of high-risk women were screened with MRI and they made up just one-quarter of women who were screened that way.

Hwang and her co-author Dr. Isabelle Bedrosian from the MD Anderson Cancer Center in Houston wrote that the data "indicate the need for better patient selection for breast MRI screening."

Both studies illustrated the use of breast MRIs balanced out after 2008.

Hwang told Reuters Health this may reveal that doctors were quick to apply the new technology however doubled back on its use once organizations put out their recommendations.

"It wasn't really until the guidelines came along when people started dialing back on using them in the less beneficial situations," she said, adding that more research is in progress to see if breast MRIs are also beneficial in diagnosing breast cancers.

Stout told Reuters Health it will be important to continue looking at how many women are receiving breast MRIs and why.

"I think monitoring this going forward is important to make sure we're using this expensive technology wisely," she said.

Hwang also mentioned a mammogram usually costs about $300. However, a breast MRI can cost between $700 and $1,200, depending on where women live.


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