Magnetic resonance imaging (MRI) is increasingly used for breast cancer screening, diagnostic evaluation, treatment planning, and surveillance, but a recent study published in JAMA Internal Medicine, "Patterns of Breast Magnetic Resonance Imaging Use in Community Practice," found that the indication for breast MRI has changed over time. Much of the increase was found among women with breast cancer risk factors, but there are still notable gaps in risk-based use.
Tracy L. Onega, PhD, associate professor of Community and Family Medicine and of the Dartmouth Institute, Geisel School of Medicine at Dartmouth, and Norris Cotton Cancer Center member, was a co-author on the paper. The findings suggest the continued need for evidence that will help align use of breast MRI, mammography, and newer imaging technologies like digital breast tomosynthesis with the most effective care.
The study used data on breast MRI and mammography collected by five national Breast Cancer Surveillance Consortium registries from 2005 to 2009 -- including the New Hampshire Mammography Network. It included 8,931 breast MRI examinations and 1,288,924 screening mammograms from women aged 18 to 79 years. Researchers found that in this period the overall rate of breast MRI nearly tripled. The most common clinical indication was diagnostic evaluation (40.3 percent), followed by screening (31 percent).
"The benefit of breast MRI includes high sensitivity for identifying breast malignancy, and national guidelines support using it for particular clinical indications," said Onega. "But compared to mammography, breast MRI is more expensive and can lead to higher false positive rates. We need to continue to evaluate and compare the effectiveness of how MRI and mammography are used and find 'the right test for the right woman at the right time'."
The above story is based on materials provided by Norris Cotton Cancer CenterDartmouth-Hitchcock Medical Center. Note: Materials may be edited for content and length.
- Karen J. Wernli, Wendy B. DeMartini, Laura Ichikawa, Constance D. Lehman, Tracy Onega, Karla Kerlikowske, Louise M. Henderson, Berta M. Geller, Mike Hofmann, Bonnie C. Yankaskas. Patterns of Breast Magnetic Resonance Imaging Use in Community Practice. JAMA Internal Medicine, 2014; 174 (1): 125 DOI: 10.1001/jamainternmed.2013.11963
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