From the July 2018 issue of HealthCare Business News magazine


“In our observational study [on nearly 4,000 women] we have shown that one can avoid interval cancers altogether if one uses MR screening,” said Dr. Christiane Kuhl, a radiologist at RWTH Aachen University and lead author of the study. “In other words, none of the women who had undergone MR every year, or even every two or three years, had breast cancers diagnosed between screening rounds. All cancer in the cohort were detected by MR way before they were clinically palpable.”

Breast MR screening is so effective because it capitalizes on the increased blood flow of cancer in comparison to the surrounding breast tissue, according to Dr. Priti A. Shah, assistant professor at VCU Health. The scan essentially “lights up” even very small tumors with the aid of the contrast agent gadolinium.


Shah cited the case of a patient with dense breasts who had a screening mammogram and MR at age 41. With a sister and mother both diagnosed with breast cancer, this patient was considered high-risk. A sub-centimeter mass found in an MR scan was noted in the left breast, which had not been visible on her mammogram. A follow-up biopsy identified the mass as a high-grade cancer. Shah said because the cancer was found early and still small, the patient has an excellent prognosis for treatment and survival.

When 49-year old Laurel Pointer, affiliate communications manager for Susan G. Komen, discovered she was at high-risk for breast cancer she took a similar approach.

"My mom, sister, aunt, and cousin are all breast cancer survivors,” said Pointer. “About the time my aunt had breast cancer reoccur for the fourth time, my mother called to let me know that she had genetic testing and had the CHEK2 mutation. I was screened, and I also carry the mutation."

With the CHEK2 mutation, Pointer carries a lifetime risk of developing the disease that is 27 percent higher than normal. Adding in other risk factors, such as having no children and being slightly overweight, multiplies the risk. After consulting with a breast surgeon/oncologist, she opted to have an MR breast screening once a year between her annual mammograms, with the first MR screening scheduled for October.

Access and affordability
The speed at which a given diagnostic test becomes standard depends on the relationship between clinical practice and insurance coverage. Currently, the availability and insurance coverage for MR breast screening, as is typical with new clinical standards, seems to be in a gray area.

July 2018 Magazine

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