Many Women at Increased Risk of Breast Cancer Refuse MRIs

Posted on December 30th, 2009 by

In a breast cancer screening study, 42% of intermediate- and high-risk women who were offered breast magnetic resonance imaging (MRI) refused the procedure. The most common reason given for refusal was claustrophobia. These results were published in Radiology.

The goal of breast cancer screening is to reduce breast cancer mortality by identifying and treating breast cancer at an early stage. Mammography (an x-ray image of the breast) is a commonly used screening tool, but women at high-risk of breast cancer may benefit from the use of other tests in addition to mammography.

MRI uses radio waves and a magnet to create detailed images of the inside of the body. The American Cancer Society recommends that women at high risk of breast cancer undergo yearly breast cancer screening with breast MRI in addition to mammography.[1] These recommendations were prompted by several studies of MRI screening of women at high risk of breast cancer. While these studies found that the addition of MRI to mammography increased the frequency of false-positive test results compared to mammography alone, it also produced important improvements in breast cancer detection.

Acceptance of breast MRI was evaluated in a breast cancer screening study known as ACRIN 6666.[2] The study enrolled women at elevated risk of breast cancer. Information about acceptance of breast MRI was available for 1,215 of the women.

  • 42% of the women declined MRI
  • The most common reasons for MRI refusal were claustrophobia (25.4%), time constraints (18.2%), and financial concerns (12.1%; the MRI was free, but some participants were worried about the costs of any additional testing that may be necessary).

These results indicate that in spite of recommendations regarding MRI screening, many high-risk women may refuse the test. This points to the need for alternative screening strategies, or efforts to make MRI more acceptable.

References:


[1] Saslow D, Boetes C, Burke W et al. American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography. CA—A Cancer Journal for Clinicians. 2007;57:75-89.

[2] Berg WA, Blume JD, Adams AM et al. Reasons women at elevated risk of breast cancer refuse breast MR imaging screening: ACRIN 6666. Radiology. 2010;254:79-87.

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