Patterns of Breast Magnetic Resonance Imaging Use in Community Practice | Breast Cancer | JAMA Internal Medicine | JAMA Network
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Author Karen J. Wernli, PhD, discusses Patterns of Breast Magnetic Resonance Imaging Use in Community Practice.

1.
US Food and Drug Administration. MQSA National Statistics. http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm. 2012. Accessed October 9, 2012.
2.
Howlader N, Noone AM, Krapcho M, et al, eds. SEER Cancer Statistics Review, 1975-2008. Bethesda, MD: National Cancer Institute; 2011. http://seer.cancer.gov/csr/1975_2008/. Accessed May 12, 2012.
3.
Stout  NK, Nekhlyudov  L.  Early uptake of breast magnetic resonance imaging in a community-based medical practice, 2000-2004.  J Womens Health (Larchmt). 2011;20(4):631-634.PubMedGoogle ScholarCrossref
4.
Elmore  L, Margenthaler  JA.  Breast MRI surveillance in women with prior curative-intent therapy for breast cancer.  J Surg Res. 2010;163(1):58-62.PubMedGoogle ScholarCrossref
5.
Smith  RA, Cokkinides  V, Brooks  D, Saslow  D, Brawley  OW.  Cancer screening in the United States, 2010: a review of current American Cancer Society guidelines and issues in cancer screening.  CA Cancer J Clin. 2010;60(2):99-119.PubMedGoogle ScholarCrossref
6.
Lehman  CD, DeMartini  W, Anderson  BO, Edge  SB.  Indications for breast MRI in the patient with newly diagnosed breast cancer.  J Natl Compr Canc Netw. 2009;7(2):193-201.PubMedGoogle Scholar
7.
Elmore  L, Margenthaler  JA.  Use of breast MRI surveillance in women at high risk for breast cancer: a single-institutional experience.  Ann Surg Oncol. 2010;17(suppl 3):263-267.PubMedGoogle ScholarCrossref
8.
Sommer  CA, Stitzenberg  KB, Tolleson-Rinehart  S, Carpenter  WR, Carey  TS.  Breast MRI utilization in older patients with newly diagnosed breast cancer.  J Surg Res. 2011;170(1):77-83.PubMedGoogle ScholarCrossref
9.
Kriege  M, Brekelmans  CT, Obdeijn  IM,  et al.  Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer.  Breast Cancer Res Treat. 2006;100(1):109-119.PubMedGoogle ScholarCrossref
10.
Leach  MO, Boggis  CR, Dixon  AK,  et al; MARIBS study group.  Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS).  Lancet. 2005;365(9473):1769-1778.PubMedGoogle ScholarCrossref
11.
Saslow  D, Boetes  C, Burke  W,  et al; American Cancer Society Breast Cancer Advisory Group.  American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.  CA Cancer J Clin. 2007;57(2):75-89.PubMedGoogle ScholarCrossref
12.
Lehman  CD, Smith  RA.  The role of MRI in breast cancer screening.  J Natl Compr Canc Netw. 2009;7(10):1109-1115.PubMedGoogle Scholar
13.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Breast Cancer. Version 3.2013. http://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed October 17, 2013.
14.
Ballard-Barbash  R, Taplin  SH, Yankaskas  BC,  et al; Breast Cancer Surveillance Consortium.  Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database.  AJR Am J Roentgenol. 1997;169(4):1001-1008.PubMedGoogle ScholarCrossref
15.
 American College of Radiology Breast Imaging Reporting and Data System Atlas. Reston, VA: American College of Radiology; 2003.
16.
Costantino  JP, Gail  MH, Pee  D,  et al.  Validation studies for models projecting the risk of invasive and total breast cancer incidence.  J Natl Cancer Inst. 1999;91(18):1541-1548.PubMedGoogle ScholarCrossref
17.
Gail  MH, Brinton  LA, Byar  DP,  et al.  Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.  J Natl Cancer Inst. 1989;81(24):1879-1886.PubMedGoogle ScholarCrossref
18.
Gail  MH, Costantino  JP, Pee  D,  et al.  Projecting individualized absolute invasive breast cancer risk in African American women.  J Natl Cancer Inst. 2007;99(23):1782-1792.PubMedGoogle ScholarCrossref
19.
Matsuno  RK, Costantino  JP, Ziegler  RG,  et al.  Projecting individualized absolute invasive breast cancer risk in Asian and Pacific Islander American women.  J Natl Cancer Inst. 2011;103(12):951-961.PubMedGoogle ScholarCrossref
20.
Rockhill  B, Spiegelman  D, Byrne  C, Hunter  DJ, Colditz  GA.  Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention.  J Natl Cancer Inst. 2001;93(5):358-366.PubMedGoogle ScholarCrossref
21.
Bluemke  DA, Gatsonis  CA, Chen  MH,  et al.  Magnetic resonance imaging of the breast prior to biopsy.  JAMA. 2004;292(22):2735-2742.PubMedGoogle ScholarCrossref
22.
Miller  JW, Sabatino  SA, Thompson  TD,  et al.  Breast MRI use uncommon among US women.  Cancer Epidemiol Biomarkers Prev. 2012;22(1):159-166.PubMedGoogle ScholarCrossref
23.
Buxton  JA, Bottorff  JL, Balneaves  LG,  et al.  Women’s perceptions of breast cancer risk: are they accurate?  Can J Public Health. 2003;94(6):422-426.PubMedGoogle Scholar
24.
Haas  JS, Kaplan  CP, Des Jarlais  G, Gildengoin  V, Pérez-Stable  EJ, Kerlikowske  K.  Perceived risk of breast cancer among women at average and increased risk.  J Womens Health (Larchmt). 2005;14(9):845-851.PubMedGoogle ScholarCrossref
25.
Haas  JS, Kaplan  CP, Gregorich  SE, Pérez-Stable  EJ, Des Jarlais  G.  Do physicians tailor their recommendations for breast cancer risk reduction based on patient’s risk?  J Gen Intern Med. 2004;19(4):302-309.PubMedGoogle ScholarCrossref
26.
Berg  WA, Gutierrez  L, NessAiver  MS,  et al.  Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer.  Radiology. 2004;233(3):830-849.PubMedGoogle ScholarCrossref
27.
Brinton  JT, Barke  LD, Freivogel  ME, Jackson  S, O’Donnell  CI, Glueck  DH.  Breast cancer risk assessment in 64,659 women at a single high-volume mammography clinic.  Acad Radiol. 2012;19(1):95-99.PubMedGoogle ScholarCrossref
28.
Berg  WA, Blume  JD, Adams  AM,  et al.  Reasons women at elevated risk of breast cancer refuse breast MR imaging screening: ACRIN 6666.  Radiology. 2010;254(1):79-87.PubMedGoogle ScholarCrossref
29.
Ozanne  EM, Drohan  B, Bosinoff  P,  et al.  Which risk model to use? clinical implications of the ACS MRI screening guidelines.  Cancer Epidemiol Biomarkers Prev. 2013;22(1):146-149.PubMedGoogle ScholarCrossref
Original Investigation
January 2014

Patterns of Breast Magnetic Resonance Imaging Use in Community Practice

Author Affiliations
  • 1Group Health Research Institute, Seattle, Washington
  • 2Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle
  • 3Department of Community and Family Medicine, Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, New Hampshire
  • 4General Internal Medicine Section, Department of Veterans Affairs, San Francisco, California
  • 5Department of Medicine, University of California, San Francisco
  • 6Department of Epidemiology and Biostatistics, University of California, San Francisco
  • 7Department of Radiology, University of North Carolina, Chapel Hill
  • 8Department of Family Medicine, University of Vermont, Burlington
  • 9Department of Radiology, University of Vermont, Burlington
JAMA Intern Med. 2014;174(1):125-132. doi:10.1001/jamainternmed.2013.11963
Abstract

Importance  Breast magnetic resonance imaging (MRI) is increasingly used for breast cancer screening, diagnostic evaluation, and surveillance. However, we lack data on national patterns of breast MRI use in community practice.

Objective  To describe patterns of breast MRI use in US community practice during the period 2005 through 2009.

Design, Setting, and Participants  Observational cohort study using data collected from 2005 through 2009 on breast MRI and mammography from 5 national Breast Cancer Surveillance Consortium registries. Data included 8931 breast MRI examinations and 1 288 924 screening mammograms from women aged 18 to 79 years.

Main Outcomes and Measures  We calculated the rate of breast MRI examinations per 1000 women with breast imaging within the same year and described the clinical indications for the breast MRI examinations by year and age. We compared women screened with breast MRI to women screened with mammography alone for patient characteristics and lifetime breast cancer risk.

Results  The overall rate of breast MRI from 2005 through 2009 nearly tripled from 4.2 to 11.5 examinations per 1000 women, with the most rapid increase from 2005 to 2007 (P = .02). The most common clinical indication was diagnostic evaluation (40.3%), followed by screening (31.7%). Compared with women who received screening mammography alone, women who underwent screening breast MRI were more likely to be younger than 50 years, white non-Hispanic, and nulliparous and to have a personal history of breast cancer, a family history of breast cancer, and extremely dense breast tissue (all P < .001). The proportion of women screened using breast MRI at high lifetime risk for breast cancer (>20%) increased during the study period from 9% in 2005 to 29% in 2009.

Conclusions and Relevance  Use of breast MRI for screening in high-risk women is increasing. However, our findings suggest that there is a need to improve appropriate use, including among women who may benefit from screening breast MRI.

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