Uptake of MRI in patients without a personal history of breast cancer (PHBC) classified as “high risk”.

Abstract

e18754 Background: The American Cancer Society (ACS) recommends annual screening MRI in addition to mammography in patients without a personal history of breast cancer (PHBC) who are ages 25-75 with a Tyrer-Cuzick (TC) score ≥ 20%. Here, we evaluate the uptake of supplemental MRI in these high-risk patients. Methods: Data was extracted from the EMR of an academic medical center for patients (ages 25-75) with a mammogram between 07/20/2020 and 07/19/2021 and a TC ≥ 20%. We assessed uptake differences in demographics, access to healthcare, and breast density in the patient populations that opted for supplemental MRI. A chi-squared analysis was used to compare the groups: 1) No supplemental screening, 2) Patients who underwent MRI supplemental screening, and 3) Patients who did not receive MRI supplemental screening. Results: Of the 1144 patients with a TC ≥ 20%, 27% (n = 307) underwent supplemental MRI screening, while 73% (n = 837) did not. Out of 635 patients with an MRI order, those who were recommended by a high-risk breast cancer (HRBC) provider (n = 227, 36%) were more likely to undergo the MRI (88%, n = 200) compared to those without a HRBC provider (33%, n = 135) (p-value < 0.001). However, the other 509 patients that were recommended MRI never followed up for further imaging or health care visits. Of the patients who were notified that they had dense breasts (n = 842, 74%), 28% (n = 237) underwent MRI, compared to those without dense breasts (18%, n = 55) (p-value < 0.001). Conclusions: 27% (n = 307 out of 1144) of women without a PHBC who are at high-risk for breast cancer underwent MRI as a supplemental breast cancer screening. Our study shows that access to a HRBC is a contributing factor to follow through with the recommended MRI as a supplemental screening. More than 80% of the patients who underwent MRI had a HRBC. Patients may still be faced with challenges, including having access to a HRBC.