Many High-Risk Women Refuse Breast MRI

Though it helps ID early breast cancer, 42 percent in study declined free test

By Kathleen Doheny
HealthDay Reporter

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TUESDAY, Dec. 22 (HealthDay News) -- For women at high risk of breast cancer, an MRI can help detect malignancies early and is often suggested in addition to annual mammograms. Yet, 42 percent of such women in a new study said no to the test.

"We were surprised that so few women wanted to have MRI, even though it was no cost to them," said study author Dr. Wendie A. Berg, a breast imaging specialist at Johns Hopkins' Green Spring Station in Lutherville, Md.

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Berg and her colleagues offered 1,215 women at high or intermediate risk of breast cancer an MRI for screening, but 512 women refused the test. They cited claustrophobia, time problems and reluctance to have the contrast medium injected as some of their reasons. They also mentioned financial concerns and the need to travel to get the test.

In an MRI, a powerful magnetic field, radio frequency pulses and a computer produce detailed pictures of organs, soft tissues, bone and other structures. MRI is often used to evaluate the heart, liver, kidney, spleen, pelvic organs, blood vessels and breasts.

Contrast material may be swallowed or injected to produce a better image. The patient is rolled into a cylindrical machine, and some have problems because of claustrophobia.

In the Berg study, the acceptability of the test was lower than expected, said Robert Smith, director of cancer screening for the American Cancer Society (ACS). "I would think most women would accept the test if their doctor suggested it," he said.

The study is published in the January issue of Radiology.

Smith said he was surprised that claustrophobia was cited more often -- by 25.4 percent of the women -- than reluctance to inject the contrast material -- 5.3 percent.

The ACS recommends MRI plus mammograms annually beginning at age 30 for certain groups of women with a high risk of getting breast cancer, which is defined as more than a 20 percent lifetime risk. For instance, those with the genetic mutation known as BRCA1 or 2 would be candidates for getting both.

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