In Reply We thank Dr Keller for drawing attention to several additional points regarding the use of breast magnetic resonance imaging (MRI) for breast cancer screening. With respect to the first comment, we concur that the attributes of a screening test include that it must be both noninvasive and inexpensive. While the $350 reported charges for an MRI by a for-profit screening center is not exorbitant, it still remains much higher than the cost of a routine screening mammogram, is a significant out-of-pocket cost for most patients, and begs the question of whether patients should cover the cost of their own cancer screening, given that MRI has not been shown to offer benefit over mammography for the general population.
Hwang ES. In Defense of Screening for Breast Cancer With Magnetic Resonance Imaging—Reply. JAMA Intern Med. 2014;174(8):1417-1418. doi:10.1001/jamainternmed.2014.803