Surge in MRI tests expectedExperts say recommendation on new breast cancer screening likely to increase requests for MRIs— By Deborah Jeanne Sergeant(Reprinted from IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper)
Although staff at the Department of Women’s Imaging at the University of Rochester Medical Center hasn’t observed an increase in MRI requests, “we absolutely anticipate an increase” because of the American Cancer Society’s recommendation, said Avice O’Connell, M.D., director of women’s imaging. O’Connell believes it’s only a matter of time before the “great clout” of the American Cancer Society catches up to insurance companies, many of which do not currently cover the cost of an MRI, about $1,000 to $2,000. A mammogram, more commonly used to detect breast cancer, is about $100. The surge in MRIs should not significantly drive up insurance costs, however. Only a small number of women truly need to receive an MRI in addition to a mammogram to screen for breast cancer. O’Connell and Dr. Charles Albrecht, medical director at Finger Lakes Radiation Oncology Center in Clifton Springs, recommend that only highrisk women talk with their doctors about receiving MRIs, such as those with multiple first-degree relatives with breast or ovarian cancer, genetic mutations indicating breast cancer, previous radiation treatment for Hodgkin’s disease from age 10 to age 30 and previous breast cancer experiences. What doctors don’t want to see is women paying for superfluous MRIs out-of-pocket in addition to or instead of routine mammograms. “Women come in with dense breasts and think that they need an MRI,” O’Connell said. “A lot of people think they are high risk because of a third cousin with breast cancer or if they’ve had cysts or lumpy breasts. The numbers [of women at risk] are much smaller than people think. Most women walking around don’t need a breast MRI. Thirteen percent risk is considered average risk.” She calls mammography, which has been used for more than 30 years, the “gold standard” in cancer detection because some cancerous material does not show up on MRIs. Albrecht agrees. “The problem with MRI as a screening device is that there’s a lot more room for false positives,” he said. “It picks up a lot more stuff that is harmless.” O’Connell said that at least half of MRIs show some tissue that will show some kind of anomaly, and half of those MRIs will require a biopsy or six-month follow-up visit, which can cause patients needless worry. MRIs can also show false negatives, missing cancer that a mammogram might pick up. She described MRI screening as “expensive, complicated, time-consuming and sensitive, but not specific.” For high-risk women, using both mammography and MRI technology provides the most comprehensive look at their breasts’ health. The American Cancer Society also recently began recommending annual mammograms at age 40 regardless of risk factors, a policy differing from organizations such as the American College of Physicians, which recommends only discussing the procedure at age 40. Albrecht said that he “feels more comfortable” with the American Cancer Society’s recommendation, and adds that annual mammograms should “start much younger than that if she’s had multiple family members with breast cancer.” O’Connell also urges patients to seek annual mammograms because it helps save lives. “Usually, we lose money on mammograms. It’s not a money-maker. But cancer is so treatable if caught at an early age. Do not think that you don’t need mammography.” |
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