by
John W. Mitchell, Senior Correspondent | July 16, 2018
From the July 2018 issue of HealthCare Business News magazine
“In an ideal world if we had endless amounts of money and MR machines, probably all of us should have MR screenings, [but] it is an expensive test currently, and it does use an injection. There is not capacity to scan every woman in the U.S., every year.” said Morris with Sloan Kettering. “So, we want to recommend it for people who are going to be having breast cancer at higher rates than the general population.”
If a patient has a 20 percent lifetime risk, insurance typically covers MR breast screening, according to Dr. Kelly Myers, assistant professor of radiology at Johns Hopkins Hospital. She is optimistic that new innovations will help increase access to the scans.
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“Recently, there has been much excitement about investigating abbreviated breast MR, which is a shortened version of the standard breast MR,” said Myers. “Studies so far have been very promising, and if abbreviated breast MR is able to find nearly as many cancers as the standard protocol MR, but with much less time in the MR, this could make the exam more affordable, and in turn, accessible to more patients.”
Shortcomings and uncertainties with MR breast screening
There are a few points of reserve to consider with MR breast screening. Dr. Christoph Lee, staff radiologist, Seattle Cancer Care Alliance and associate professor of radiology at the University of Washington School of Medicine, said that no trials have looked at the mortality benefit from supplemental MR screenings. Lee also said that patients should be informed about the possibility of false positives, which can create significant anxiety and lead to unnecessary treatment.
Still, Lee believes that women should have the choice to receive MR breast screening if they are at high lifetime risk.
“We don’t have randomized control trials looking at mortality as an endpoint, and we're never going to," Sloan Kettering’s Morris said. "We have to use surrogate endpoints – size, grade, nodule positivity – to show there is a benefit to the screening.”
