Uptake of screening breast MRI in high-risk patients without a personal history of breast cancer.

Abstract

e13527 Background: Early detection of breast cancer reduces breast cancer mortality. Women at higher-than-average risk for the development of breast cancer should begin mammographic screening at an earlier age than their average-risk counterparts and should consider supplemental screening. The American College of Radiology (ACR) Commission on Breast Imaging recommends screening MRI as the supplemental imaging modality of choice for most higher-than-average risk women. This includes women with a lifetime risk of breast cancer of 20% or greater, according to breast cancer risk assessment tools. In this study, we evaluated the uptake of supplemental screening MRI in patients ages 25-85 classified as high risk (Tyrer Cuzick (TC) score greater than 20%) without a personal history of breast cancer (PHBC). Methods: Data was extracted from the EMR of an academic medical center for patients with a mammogram between 07/20/2020 to 07/18/2025, a TC ≥ 20%, and who did not have a personal history of breast cancer. We assessed differences in MRI screening uptake based on access to healthcare, patient demographics, and mammographic breast density in the population that was eligible for supplemental MRI. Chi-squared analyses were used to compare the groups that did and did not undergo supplemental screening MRI. Results: There were 5647 patients identified as having a TC ≥ 20%. Of those, 35% (n =1962) underwent supplemental MRI screening, while 65% (n =3685) did not. Patients who saw a high-risk breast cancer (HRBC) provider (n =1722, 30%) were far more likely to undergo MRI (n =1178/1722, 68%) compared to those without a HRBC provider (n =784/3925, 20%) (p-value <0.001). Patients who were successfully contacted by a nurse navigator (NN) (n = 2037) were also more likely to undergo MRI (n =817/2037, 40%) compared to those who were unable to be reached by a NN (n = 1016/3610, 28%) (p-value < 0.001). Conclusions: There are a variety of factors that influence whether women at a higher-than-average risk for developing breast cancer complete a recommended screening MRI. While multiple variables in our study displayed statistical significance in the uptake of screening breast MRI, having a HRBC provider and being contacted by a NN were the factors that most strongly correlated with patients undergoing screening MRI.