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Purpose <p>Due to increased sensitivity for early detection compared to mammography, breast MRI is increasingly used for surveillance screening in women with breast cancer, especially in those diagnosed at a young age or with dense breasts. We investigated factors associated with receipt of breast MRI in women with operable breast cancer.</p> Methods <p>Our cohort included women with stage 0-III breast cancer seen at an urban academic medical center from January 2018 to June 2023. We collected demographic and clinical data from the electronic health record. The primary endpoint was receipt of surveillance breast MRI &gt; 1&#xa0;year after diagnosis. Multivariable logistic regression was used to identify factors associated with breast MRI use.</p> Results <p>Among 1989 racially/ethnically diverse women, a total of 355 (17.8%) women received at least one surveillance breast MRI. In multivariable analysis, Hispanic and non-Hispanic Black women were less likely to receive surveillance breast MRI than non-Hispanic White women (odds ratio [OR] = 0.44, 95% confidence interval [CI] = 0.31–0.63 and OR = 0.57, 95% CI = 0.38–0.86, respectively). However, compared to women with commercial insurance, women with Medicaid were more likely to receive surveillance breast MRI (OR = 1.57, 95% CI = 1.10–2.25). Results were similar when restricting to women diagnosed under age 50 or with dense breasts. Receipt of breast MRI was associated with smaller breast tumor size at recurrence (p = 0.016). Among women who received breast MRI, 22.5% had a false-positive biopsy compared with 11.5% of women who received mammography alone (p &lt; 0.001).</p> Conclusion <p>Receipt of breast MRI among breast cancer survivors differed by race, ethnicity, and insurance payor mix. These disparities in the use of breast MRI highlight the need for more standardized guidelines surrounding the optimal role of surveillance breast MRI among women with breast cancer, which can inform targeted public health interventions aimed at promoting more equitable screening practices in this population.</p>

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Factors associated with receipt of surveillance breast MRI among racially and ethnically diverse women with operable breast cancer

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • Preeti Kakani,
  • Vicky Ro,
  • Julia E. McGuinness,
  • Alissa Michel,
  • Katherine D. Crew

摘要

Purpose

Due to increased sensitivity for early detection compared to mammography, breast MRI is increasingly used for surveillance screening in women with breast cancer, especially in those diagnosed at a young age or with dense breasts. We investigated factors associated with receipt of breast MRI in women with operable breast cancer.

Methods

Our cohort included women with stage 0-III breast cancer seen at an urban academic medical center from January 2018 to June 2023. We collected demographic and clinical data from the electronic health record. The primary endpoint was receipt of surveillance breast MRI > 1 year after diagnosis. Multivariable logistic regression was used to identify factors associated with breast MRI use.

Results

Among 1989 racially/ethnically diverse women, a total of 355 (17.8%) women received at least one surveillance breast MRI. In multivariable analysis, Hispanic and non-Hispanic Black women were less likely to receive surveillance breast MRI than non-Hispanic White women (odds ratio [OR] = 0.44, 95% confidence interval [CI] = 0.31–0.63 and OR = 0.57, 95% CI = 0.38–0.86, respectively). However, compared to women with commercial insurance, women with Medicaid were more likely to receive surveillance breast MRI (OR = 1.57, 95% CI = 1.10–2.25). Results were similar when restricting to women diagnosed under age 50 or with dense breasts. Receipt of breast MRI was associated with smaller breast tumor size at recurrence (p = 0.016). Among women who received breast MRI, 22.5% had a false-positive biopsy compared with 11.5% of women who received mammography alone (p < 0.001).

Conclusion

Receipt of breast MRI among breast cancer survivors differed by race, ethnicity, and insurance payor mix. These disparities in the use of breast MRI highlight the need for more standardized guidelines surrounding the optimal role of surveillance breast MRI among women with breast cancer, which can inform targeted public health interventions aimed at promoting more equitable screening practices in this population.