Trends in screening breast magnetic resonance imaging use among US women, 2006 to 2016

Abstract

BACKGROUND: Supplemental breast cancer screening with breast magnetic resonance imaging (MRI) is recommended for women at high risk of breast cancer. To the authors' knowledge, recent national trends in breast MRI use are unknown. METHODS: The authors used claims data from a large national insurer to calculate screening breast MRI rates from 2006 to 2016 in a US cohort of 10 million women aged 20 to 64 years. Use was stratified by subgroups of women with a BRCA mutation, family history of breast cancer, and prior breast cancer history and stratified by age. Joinpoint regression evaluated annual changes in trends. RESULTS: The total sample included 37,447 screening breast MRI examinations in 25,617 women. Overall screening breast MRI rates were low and increased from 2.9 to 12.1

Use of breast surveillance between women with pathogenic variants and variants of uncertain significance in breast cancer susceptibility genes

“…In contrast, breast MRI rates were much higher in this cohort of survivors who underwent genetic testing (34.9% for P/LP and 14.3% for VUS in year 1) compared to 9% in the population level 3 . Our rates appear to be greater than results from a recent population level study that reported 0.12% rate of MRI in the overall population and 2.1% among BRCA mutation carriers 19 that likely indicates the influence of cancer care settings on receipt of guideline concordant medical management. In addition, our largely non‐Hispanic White, well‐insured study population likely have the resources to access routine surveillance that is known to be influenced by socioeconomic characteristics 20 .…”

Downstream Mammary and Extramammary Cascade Services and Spending Following Screening Breast Magnetic Resonance Imaging vs Mammography Among Commercially Insured Women

“…While our estimates of total additional spending are modest, they add up across the population. A claims-based study 28 showed about 0.18% of all US women aged 40 to 64 received screening MRI in 2016 (0.19% among women aged 40-49; 0.17% among women aged 50-64), with current rates likely to be higher. Extrapolating to 52.6 million women aged 40 to 64 based on 2020 US census data, this would entail about $53.4 million in additional total spending on mammary cascades and $4.0 million on extramammary cascades nationwide.…”

“…Specifically, bilateral breast MRI codes do not distinguish between screening and diagnostic indications, although we took several analytic steps to exclude diagnostic MRI consistent with prior literature. 28 , 29 In addition, potential cascade events necessarily include services commonly performed for various indications, so while we report these rates, our main conclusions focus on additional event rates in the breast MRI group compared with the mammography group. The falsification test offers further reassurance that the additional cascade events reported may plausibly be associated with the index event.…”

“…We took these steps based on prior literature to optimize the likelihood of identifying a screening MRI since bilateral breast MRI procedure codes do not specify screening vs diagnostic indication. 28 , 29 Among women who did not have a breast MRI, we identified those who had a bilateral screening mammogram claim between January 1, 2017, and June 30, 2018; were aged 40 to 64 years on the date of the mammogram; were continuously enrolled from 12 months before the mammogram through 6 months after the mammogram; did not have a breast MRI claim in the preceding 12 months; and did not have a claim with a breast cancer diagnosis code in the preceding 12 months or on the date of the index mammogram.…”

A comparative study based on serum SERS spectra in and on the coffee ring for high precision breast cancer detection

“…[2] Unfortunately, a lot of cancer patients were diagnosed in advanced stages or metastatic stage, missing the best time for treatment. At present, despite the abundant clinical diagnostic methods, including magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), and mammography combine with histopathology or cytology, [3][4][5][6][7] these methods suffer from the high cost, complicated procedure, invasiveness, and subjective visual identification based on experience of pathologist. Thus, over treatment or missed diagnosis possibly exists due to the false-positive or false-negative caused by above methods, leading to miserable outcomes to the patients.…”