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Outcomes of Abbreviated MRI (Ab-MRI) for Women of any Breast Cancer Risk and Breast Density in a Community Academic Setting

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Abbreviated magnetic resonance imaging (Ab-MRI) has been evaluated for elevated breast cancer risk or dense breasts but has not been evaluated across all risk profiles.

Methods

Patients selected underwent Ab-MRI from February 2020 to September 2021. Women were older than aged 30 years, up to date with screening mammography, and paid $299 cash.

Results

A total of 93 patients were identified with a mean age of 52 years; 92.5% were Caucasian, 0% black, and 97.9% were from high socioeconomic status. Mean Gail score was 14.2, and 83.3% had a lifetime risk of breast cancer <20%. Reasons for Ab-MRI: dense breasts (36.6%); family history (24.7%); palpable mass (12.9%). Providers ordering: OBGYN (49.5%); breast surgeon (39.1%); primary care (6.6%). Thirteen biopsies (14%) detected one breast cancer. 31.1% had a change in follow-up screening: 58.6% 6-month MRI, 20.7% 6-month mammogram, and 10.3% 6-month ultrasound. Negative predictive value was 100% (95% confidence interval [CI]: 95-100%, p < 0.0001). Sensitivity was 100% (95% CI: 2.5-100%, p < 0.0001), and specificity was 87% (95% CI: 78.3-93.1%, p < 0.0001) compared with 77.6% and 98.8% for mammography. Only one cancer was detected: cost of $27,807 plus cost of 13 MRI or ultrasound (US)-guided biopsies and additional follow-up imaging. Historically 20% of abnormalities detected on full MRI are malignant; however, 7.7% of ab-MRI abnormalities were malignant

Conclusions

One third of women were recommended a change in follow-up, which predominantly included a 6-month MRI. Ab-MRI may introduce average risk women to unnecessary follow-up and increased biopsies with a lower cancer detection rate. Ab-MRI should be evaluated closely before implementation.

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Acknowledgment

Thank you to the breast cancer team at Main Line Health for making this study possible and always working to improve the care of our breast cancer patients. There was grant support for this work from the Sharpe Strumia Foundation Grant number SSRF2021-11.

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Authors and Affiliations

  1. The Bryn Mawr Hospital, Bryn Mawr, PA, USA

    Kaitlyn Kennard MD, Lina M. Sizer DO, Catherine Carruthers MD, William B. Carter MD & Thomas G. Frazier MD

  2. Lankenau Medical Center, Wynnewood, PA, USA

    Kaitlyn Kennard MD, Olivia Wang MD, Robin Ciocca DO, Jennifer Sabol MD & Ned Z. Carp MD

  3. Center for Population Health at Lankenau Institute for Medical Research, Wynnewood, PA, USA

    Kaitlyn Kennard MD, Stephanie Kjelstrom MPH & Sharon Larson PhD

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  1. Kaitlyn Kennard MD
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  2. Olivia Wang MD
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Correspondence to Kaitlyn Kennard MD.

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Kennard, K., Wang, O., Kjelstrom, S. et al. Outcomes of Abbreviated MRI (Ab-MRI) for Women of any Breast Cancer Risk and Breast Density in a Community Academic Setting. Ann Surg Oncol 29, 6215–6221 (2022). https://doi.org/10.1245/s10434-022-12194-9

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