MedWire News: Claustrophobia is preventing a lot of women at high risk for breast cancer from undergoing supplemental magnetic resonance (MR) imaging, researchers report.
In 2007, the American Cancer Society (ACS) recommended annual supplemental screening with MR imaging in addition to mammography in high-risk women, note Wendy Berg from Vanderbilt University School of Medicine in Nashville, Tennessee, USA, and colleagues.
But in the recent American College of Radiology Imaging Network (ACRIN) 6666 Protocol study, the uptake of supplemental MR imaging in women with high-risk breast cancer was low.
Surprised by this finding, Berg et al set out to determine the reasons why the 2809 women at high risk for breast cancer enrolled in this study either did not complete or refused contrast-enhanced MR screening.
Women invited to enlist in the MR substudy had to have completed three rounds (at 0, 12, and 24 months) of annual screening with mammography and ultrasound. Participants were required to undergo MR imaging at 6 months, MR imaging-guided or ultrasound-guided biopsy as necessary, and clinical follow-up at 11 to 14 months thereafter.
The results showed that of the 1215 evaluable women, just 703 (57.9%) agreed to participate in the MR substudy, of whom 627 (51.6%) actually successfully completed the protocol and 512 (42.1%) did not.
The most common reasons for not undergoing supplemental MR screening included claustrophobia (25.4%) and time constraints or other priorities (18.2%). Other reasons included financial concerns (12.1%), lack of a physician referral or belief that MR was indicated (7.8%), and the inability to tolerate MR imaging (7.6%).
“Study results suggest that there may be a large group of women at elevated risk of breast cancer for whom MR imaging would not be acceptable,” state the researchers.
They conclude that in these cases supplemental screening with combined ultrasound and mammography should be considered, so long as women are informed of the high rate of false-positive results and reduced sensitivity.
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