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Physician counseling boosts likelihood of women getting breast cancer screening MRI
■ Patients at high risk of getting the disease are more likely to overcome claustrophobia and other objections when doctors explain the benefits.
By Susan J. Landers — Posted Jan. 13, 2010
Women at high or intermediate risk of breast cancer were more likely to agree to have an MRI screening test if they were counseled by their physicians about the benefits of the test, according to a new study.
Researchers from the American College of Radiology Imaging Network set out to determine why 42% of women at elevated risk for breast cancer declined an all-expenses-paid MRI screening exam. Their findings were published in the January Radiology (link).
Of the 1,215 women offered the MRI in the study, 512 declined to participate. The main reason, given by 25% of those who declined the exam, was claustrophobia. Another 18% said they didn't have time for the exam, and 5% cited a reluctance to have the necessary injection of contrast material.
But when the women were counseled by their physicians, they seemed more likely to overcome their reservations and get the screening exam, said lead author Wendie Berg, MD, PhD, a breast imaging specialist at Johns Hopkins' Green Spring Station in Lutherville, Md.
"We saw highly variable participation depending on how things were presented," she said. "The simple act of making sure the woman was aware of the increased potential for detecting cancer using the MRI was certainly important."
Physicians were to advise women of the increased potential for detecting cancer using an MRI -- that it was more sensitive than the combination of mammogram and ultrasound.
When all the information was presented, most women wanted to proceed with the MRI, Dr. Berg said. At her center, 81% of women who were offered the screening completed it. In other centers, the acceptance rate was as low as 29%.
For patients who decline an MRI, screening with ultrasound to supplement mammography is an option, Dr. Berg said. "We know that adding ultrasound to mammography can increase detection of mostly node-negative invasive cancers by about 30%. Compare this to clinical exams, which increase detection rates by only 3% over mammography alone."
