Women of average risk for breast cancer now have access to Duke’s abbreviated screening breast MRI program—a more sensitive preventive screening option for detecting clinically significant disease. Duke is the first center in the North Carolina Triangle region to offer this service.
Traditional screening breast MRI is generally covered by insurance plans for women at high risk for breast cancer (defined as greater than a 20% lifetime risk), but women at average risk, including many with dense breast tissue, often do not have insurance coverage for this potentially lifesaving additional screening.
Currently, there is no widely prescribed screening algorithm with breast MRI for women of average risk, notes Eun L. Langman, MD, a Duke radiologist and breast imaging specialist. Routine 3-D screening mammography catches about six cancers out of 1,000, but for women who may want to consider additional screening, “the best answer is breast MRI,” she says.
The abbreviated option requires a patient to be in the MRI scanner for only 10 minutes, with a single set of images acquired after contrast. “Cancers rapidly enhance and will light up on the single phase. By minimizing our scan time, there is less opportunity for patient discomfort, and there is also decreased operational cost,” Langman explains.
Breast MRI screening catches an additional 10 to 15 cancers out of 1,000 patients when added to screening mammography, she adds, and it is better at finding more aggressive, clinically relevant tumors that may be mammographically occult or mistaken for a benign lesion based on morphology alone. By comparison, screening breast ultrasound may catch only four more cancers in 1,000.
To decrease the chance of a false positive result, additional imaging sequences are performed on the patient’s initial abbreviated screening breast MRI study if it is the patient’s first-ever breast MRI. Subsequent imaging will be performed with the true abbreviated protocol, Langman says.
The abbreviated screening breast MRI study can be requested by physician referral for an out-of-pocket cost that is significantly less expensive than a traditional MRI when not covered by insurance.