According to a study published today in Academic Radiology, only 13% of women who were referred for additional MRI testing due to an increased risk of breast cancer actually completed the additional testing.
Breast cancer risk factors
Risk factors, including the woman's age, her ethnicity, and whether or not there's a family history of breast cancer, are used to calculate her BCRA risk assessment. This tool used to calcuate this score is based on the Gail model, named after Dr. Mitchell Gail, who developed the statistical analysis method. A higher score correlates with a higher risk for breast cancer.
Screening for breast cancer
During a breast cancer screening, doctors take a number of factors into consideration. High risk assessment scores, as well as obviously problematic mammography results, should result in additional tests so that doctors can treat the cancer at an early stage. In this study, researchers evaluated 64,659 women and noted that follow-up was rare, even after mammography results included a recommendation to the physician for an MRI due to a Gail score showing a lifetime risk of over 20%. Of the women with elevated risk, only 13.9% received the recommended MRI within one year.
Unfortunately, there are no additional data points to explain whether this is the result of women choosing not to accept the additional testing, whether primary care physicians are simply not passing along the referral, or some combination of the two. As Deborah Glueck, PhD, senior author of the paper, says, "Did women never hear the recommendation from their physician? Did they choose not to follow through? Did they go elsewhere for an MRI? We don't know."
Improving Screening Methods
This study begs additional research, to determine where the shortfall lies. If physicians are not passing the information along, then patients may need to be empowered to receive results directly. If patients are not pursuing the necessary screenings, patient education may be the answer. Either way, with the improved screening methods available to patients, there is no excuse for failure to take advantage of today's breast cancer detection technology.
Resources:
Brinton JT, Barke LD, Freivogel ME, Jackson S, O'Donnell CI, Glueck DH.Breast cancer risk assessment in 64,659 women at a single high-volume mammography clinic.(2012). Accessed January 31, 2012.
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