"Given that MRI is promoted as a very sensitive test to identify early breast cancer, we were surprised that barely half of women at increased risk for breast cancer would undergo MRI even when offered at no cost," said Wendie A. Berg, M.D., Ph.D., breast imaging specialist at American Radiology Services, Johns Hopkins – Green Spring Station in Lutherville, Md. "This suggests the need for alternative methods, such as ultrasound, to help screen women at increased risk for breast cancer."
As part of the American College of Radiology Imaging Network (ACRIN) 6666 trial, Dr. Berg and colleagues set out to gauge patient acceptance of MRI as a breast screening tool. For the MRI study, 1,215 eligible women at intermediate or high risk for breast cancer enrolled in the ACRIN 6666 trial were offered a contrast-enhanced screening MRI exam. Of those women, only 703 (57.9 percent) agreed to the exam and only 51.6 percent completed the exam per protocol.
The chief reason given for nonparticipation was claustrophobia. One-quarter of the women who refused the exam, or 130 out of 512, cited claustrophobia as the reason. Ninety-three (18 percent) cited time constraints, and 62 (12 percent) cited financial concerns involving insurance. Other reasons for refusal included absence of indication for the exam, lack of interest, medical inability to tolerate MRI, reluctance to receive intravenous injection, fear of further testing or biopsy, MRI scheduling, distance and contrast agent allergies.
Among the 703 who initially agreed to participate, 55 did not undergo the exam for various reasons, including withdrawal of consent, scheduling problems and missed appointments. An additional 21 patients did not complete the exam, had unreadable results or did not meet the protocol deadline. Ultimately, only 627 or 51.6 percent of the eligible women completed a screening MRI. Participation was higher among women with very high lifetime risk of cancer than among women with intermediate risk.
MEDICA.de; Source: Radiological Society of North America