With National Breast Cancer Awareness Month fast approaching, the role of MRI is becoming increasingly important, especially in women with dense breast tissue.
In this quarter’s curated content, you receive the highlights of four timely papers that touch on the issues and their potential significance to your patients and your practice:
Supplemental MRI Helps Reduce False Positives
According to a report from the second screening round of the DENSE Trial, the incremental cancer detection rate was 5.8 per 1000, compared with 16.5 per 1000 in the first round. This was accompanied by a strong reduction in the number of false-positive results.1
Why this matters: These data support the value of supplemental MRI screening in reducing false-positive results, as well as reducing health care costs and patient anxiety among women with dense breast tissue.
The individuals who appear are for illustrative purposes. All persons depicted are models and not real patients or healthcare professionals.
Dense Breast Tissue: A Policy and Practice Paradox?
In a paper published in Insights Imaging, the authors point out: “The high-level evidence supporting breast MRI screening in women with extremely dense breasts is failing to persuade policy makers to translate this into clinical practice.”2
Breast MRI screening in high-risk women was adopted based on the evidence shown in randomized controlled trials (RCTs). However, despite similar science shown in the The DENSE Trial, breast MRI screening of women with extremely dense breasts has not been adopted in clinical practice.
Why this matters: The authors shed light on the challenges in translating radiological research into clinical practice, despite the use of the evidence-based medicine (EBM) theory.
The paper concludes with a statement attributed to 1967 Nobel Laureate in Chemistry, Manfred Eigen, “In theory, there is no difference between theory and practice. But in practice, there is.”
The individuals who appear are for illustrative purposes. All persons depicted are models and not real patients or healthcare professionals.
Can We Improve the Screening Re-Attendance Rate?
In a recently published paper, the authors contend that the willingness of women with dense breasts to re-attend an ongoing MRI screening study is high. However, if widespread supplemental MRI screening is to be implemented, the authors emphasize the need to improve the MRI experience.3
The paper reported a correlation between the lower re-attendance rate and the women who experienced moderate to high levels of pain, discomfort, or anxiety during their previous MRI screening round. A large number of women also mentioned that exam-related inconvenience was a reason for discontinuation.
Why this matters: Finding ways to reduce anxiety, discomfort, and inconvenience can go a long way to convincing higher-risk women to follow up on these critical screening exams, and can help differentiate your practice.
What’s Keeping Women From Their Annual Mammographies?
Nearly 40% of women in their 40s would delay the start of regular breast cancer screening, after learning about some of the potential downsides of the procedure.4
That’s according to the results of a recent nationwide survey, funded by the National Cancer Institute, among women in their 40s. The survey showed these women would prefer to have mammography at an older age, especially after learning the benefits and harms of screening.
The survey said women who wanted to delay their mammography screening were at lower breast-cancer risk than those who wanted it at their current age. Many women found information about the benefits and harms of mammography surprising.
Why this matters: The survey said the topic of overdiagnosis was surprising information for 37.4% of participants versus 27.2% for information about false positive results and for 22.9% for information about screening benefits. This supports better education for women about breast screening, especially the use of MRI, to help reduce concerns about overdiagnosis and false positives.
