Following the release of the 2018 American College of Radiology (ACR) recommendations for breast cancer screening in breast cancer survivors, significantly more women now reach eligibility for supplemental breast MRI.
Prior to 2018, the National Comprehensive Cancer Network and the American Cancer Society recommended that women at higher-than-average risk undergo supplemental breast MRI screening only if they had a personal history of breast cancer (PHBC) in addition to carrying a hereditary breast cancer gene mutation. In 2018, the ACR published their own updated clinical practice recommendations, reiterating those prior guidelines while also expanding on them to include women who have dense breast tissue or a diagnosis of breast cancer before the age of 50.
Experts from an urban academic medical center in Chicago recently detailed the impact of the recommendations at their institution in the Journal of the American College of Radiology, reporting a 15-fold increase in the number of breast cancer survivors who were potentially eligible for supplemental breast MRI following the updated 2018 guidelines [1].
This figure is based on their analysis of 2,950 patients of their institution who self-reported PHBC between the summer of 2020 and 2021. When adhering to pre-2018 guidelines, just 3.6% of those patients were considered eligible for supplemental breast MRI. In comparison, 61% were eligible under the ACR's updated recommendations.
Although the study was limited to a single institution, experts involved in it suggested that the marked increase in eligibility observed in their work offers insight into the potential impact of the updated recommendations, as well as how to implement them most equitably and effectively.
“Given the major increase from 3.6% to 61% of patients recommended supplemental breast MRI demonstrated in our study, significant attention should be given to implementation efforts,” corresponding author Jordan Lieberenz, with Rush University Cancer Center in Chicago, and colleagues suggested. “This includes consideration for how to identify eligible patients, managing MRI capacity, patient and provider education, and payor coverage.”
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.