in average-risk women, the decision to offer additional screening and which supplemental tool to use can become more complicated.
Overall, women with a lifetime risk under 15% are considered average risk, while those with a lifetime risk, over 20% are deemed high risk, with certain factors weighing heavily on that risk assessment.
Although the cancer detection rates associated with these supplemental screening approaches depend on a patient's risk level and breast density, the benefit of detecting more cancers needs to be weighed against the drawback of introducing more false-positive findings and increasing the risk for overdiagnosis.
Overall , breast MRI with and without the contrast agent gadolinium significantly increases cancer detection over other screening approaches. An advantage of abbreviated MRI over standard MRI is the appointment time. Standard MRI might take an hour, while the abbreviated scan typically takes about 10 minutes or less,"so the exam is easier to complete for some patients who might have difficulty lying still inside the scanner," Niell said.
"These are helpful numbers to share with your patients to give them realistic expectations," Niell said."We find a lot more cancers, but we do have to do more biopsies." Regarding the false-positive issue, Berg noted that the rates of false-positive findings decreased significantly between the first year of supplemental MRI to the second.the USPSTF guidelines, Joann G. Elmore, MD, MPH, of University of California, Los Angeles, and Christoph I. Lee, MD, MS, of the University of Washington, Seattle, agreed that"MRI is the supplement of choice at this time" for women meeting high-risk criteria for supplemental breast screening.
Source: Healthcare Press (healthcarepress.net)
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