What to expect after a screening breast MRI vs. mammography alone

Diana Buist and BCSC find screening MRI leads to more biopsies, finding fewer cancers, regardless of personal history of breast cancer: JAMA Internal Medicine.

Diana S.M. Buist, PhD, senior investigator at Kaiser Permanente Washington Health Research Institute, answered these questions.

Q: What did you discover?

My colleagues at the Breast Cancer Surveillance Consortium (BCSC) and I found this when we looked at the rates of core and surgical biopsy in the 90 days following screening MRI compared with mammography. The BCSC is the nation’s largest and most comprehensive collection of information on screening for breast cancer, funded by the National Cancer Institute (NCI).

In women who had screening mammograms compared to screening MRI, biopsy rates were 2 times higher among women with a personal history of breast cancer — and 5 times higher among women who had never had the disease. Remarkably, these more-intensive breast biopsies did not result in higher cancer yield. And women’s risk for breast cancer did not explain the differences in core and surgical biopsy rates between MRI and mammography, as we published in “Breast Biopsy Intensity and Findings Following Breast Cancer Screening in Women With and Without a Personal History of Breast Cancer” in JAMA Internal Medicine.

Q: For which women is screening with MRI advised?

Q: What happens after screening?

Q: Did your results surprise you?

A breast screening MRI image

Q: What does this mean for women and their care providers?

Q: What is special about your study?

Q: What’s next?

Our goal is risk stratification so that we can personalize screening strategies for women based on their personal factors and risk.

We are Kaiser Permanente Washington Health Research Institute (KPWHRI). This is the home of our Healthy Findings blog. https://www.kpwashingtonresearch.org

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