Breast cancer screening with MRI underutilized by high-risk groups

Researchers, investigating how community practices are following breast cancer screening guidelines, found that high-risk individuals, especially those with a family history of the disease, were not receiving additional MRI scans to help in early detection.

Led Deirdre A. Hill, MPH, with the University of New Mexico School of Medicine, the study was published Dec. 7 in the Journal of General Internal Medicine.

The researchers used data from the Breast Cancer Surveillance Consortium, examining 1,499 of 348,955 women who also underwent MRI. Hill et al. looked at who received MRI compared to family history and other breast cancer risk factors.

Approximately 83 percent of those receiving MRI did not meet professional guidelines, with 35.5 percent in low to average risk.

“Our data suggest use of screening MRI is not in concordance with professional society recommendations,” Hill wrote. “We found that at least 6.3 percent of women at high-risk for breast cancer, defined as two or more first-degree relatives with breast cancer, underwent screening MRI. In contrast, screening MRI was received by at least 0.36 percent of women who had fewer than two first-degree relatives with breast cancer. While the latter finding might seem of limited consequence, the continued growth of MRI use in a low-risk population poses issues for effective resource utilization.”

Increased screening in low-risk populations can result in waste through improper asset allocation. Also, the researchers wrote, increased detection without evidence of survival benefits suggests potential harm from overdiagnosis.