Screening for Breast Cancer with MRI



Photo provided by ProScan Imaging

Most women are familiar with mammography as the routine screening test for breast cancer. What they might not know are the recommendations for breast MRI.     

“Breast MRI is 2 to 2½ times more sensitive than all other modalities at picking up a multiplicity of cancers in high-risk patients,” says Dr. Stephen Pomeranz, CEO and medical director of ProScan Imaging.

A breast MRI (magnetic resonance imaging) uses magnetic field energy, rather than X-ray radiation, to provide a view inside the breast. It is a highly reliable test with a negative predictive value of 98 percent. In other words, when an MRI is read as negative, it truly is negative 98 percent of the time.

“That’s not true for other modalities where the true negative predictive value is only 75 percent or less,” Dr. Pomeranz says.

While a mammogram is the most widely used test for breast cancer screening, there are instances in which a breast MRI is recommended. For example, when a woman has dense breasts, a breast MRI will be more effective in detecting cancer.

Why? Dense breasts have more fibrous and glandular tissue than normal breasts. This tissue appears white on a mammogram film, making it more difficult for a radiologist to see a cancerous spot, which also appears white.

If a woman receives a mammogram, and it shows that she has dense breasts, she will receive a letter informing her. In such cases, a breast MRI is recommended.  

Women with dense breasts are not the only ones who should consider MRI. Women with breast implants are highly suited for breast MRI, as mammograms have trouble penetrating through both the breast and the density of the implant. A breast MRI is also recommended for women whose lifetime risk for breast cancer is 20% or higher (the normal lifetime risk is about 8.7%).  There are several factors that contribute to a woman’s risk for breast cancer, including age, age at the start of menstruation, age at first live birth, and number of first degree relatives with breast cancer.

Breast MRI goes beyond cancer detection. It is used in women with breast cancer to evaluate and stage the cancer so treatment options can be decided. With an aggressive or genetic cancer, it is also used to make sure there are no other cancers present.

While breast MRI is a valuable tool, it is not recommended for every patient. People who are pacemaker dependent, claustrophobic or unable to lie on their stomach are not candidates for the procedure.

Cost can also be a hindrance. Hospitals charge as much as $4,000 for an MRI. ProScan Imaging offers a diagnostic breast MRI, including the read fee, for $1,200 and a screening breast MRI for $399. A diagnostic breast MRI is usually covered by insurance. However, a screening breast MRI, while highly accurate and comparable for screening in pure detection, is not routinely covered by insurance.

“The difference between the two is the diagnostic MRI is a little more specific at telling you the cancer type,” explains Dr. Pomeranz.  “But they are equally good at detection.” 

A screening breast MRI is recommended for patients with family history and for those who have dense breasts, but have had normal mammograms and have not discovered any concerning abnormalities in their breasts.

Steve and Penny Pomeranz, with Cris and Holly Collinsworth, launched the Cris Collinsworth ProScan Fund (CCPF) 15 years ago. The CCPF Pink Ribbon Centers offer mammography, ultrasound, DEXA, biopsy and other breast imaging services at their locations in Over-the-Rhine, Madisonville and Tri-County.

“It’s our organization’s mission to raise the bar of care,” Dr. Pomeranz says. “The Pink Ribbon Centers are staffed by survivors and compassionate Greater Cincinnatians taking care of women in our community.” 

CCPF is also developing a program to make breast MRI more accessible and affordable for the Greater Cincinnati community, especially the underserved population.

Other Pink Ribbon programs include Cruisin’ for a Cure Vans, which have provided more than 2,200 free rides to and from appointments. The Pink Ribbon Bag program has distributed more than 4,500 free gift bags to women newly diagnosed with breast cancer, encouraging them along their healing journey. The Mammogram Match Program has provided more than 3,750 free mammograms for uninsured and underinsured patients. 

The Pink Ribbon Empowerment Program (PREP) has taught thousands of women the importance of breast health through interactive presentations. The recent focus of this program is to provide education that gives women the most up-to-date information so they can make informed decisions about their health. One avenue CCPF is providing this education to the community is through Dr. Pomeranz’s “Power of Prevention” lectures. The lectures explain the difference in breast MRI and mammography and who is a candidate for breast MRI. 

ProScan Imaging has the most experience in the United States reading breast MRI and has been involved in various clinical trials. “We’ve watched the technology evolve and become mainstream,” says Dr. Pomeranz. 

To learn more about breast MRI vs. mammography, contact CCPF at 1.866.557.PINK or www.ccpf.org. For information about ProScan Imaging, call 877.776.7226 (PROSCAN), email customerservice@proscan.com or visit proscan.com.