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Does Your Patient Need Supplemental Screening for Breast Cancer

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New low-cost, self-pay option at UH targets women with dense breasts

UH Clinical Update - January 2018

 

Half of all American women have dense breasts. Because increased breast density both lowers the sensitivity of mammography and increases the risk of developing breast cancer, dense-breasted women may benefit from supplemental screenings to detect cancers that may not be visible on their mammogram.

University Hospitals Cleveland Medical Center is now offering this supplemental screening as a low-cost, self-pay option. Fast breast MRI is available for $250 at certain UH locations (see below). MRI is the most sensitive tool for detecting breast cancer, even after a negative mammogram.

cancer detection rates/1,000 women screened
Modality CDR/1,000
Digital Mammography 2-7
DBT +0.5-2.7
Screening Ultrasound +1.8-4.6
Fast MRI +15.5-18.1
"+" indicated additional cancers detected compared to digital mammography

 

While the conventional breast MRI study (45 minutes) is tailored for women with a very high risk for developing breast cancer (such as BRCA1/2 genetic mutations), the fast breast MRI (10 minutes) is a supplemental screening for women with dense breast tissue who do not meet the lifetime breast cancer risk level for a full MRI study. The fast breast MRI takes about 10 minutes, requires an IV injection of macrocyclic MRI contrast and will be read by fellowship-trained breast imaging radiologists. Fast breast MRI is typically scheduled on day seven to 14 of a woman’s menstrual cycle.

Fast breast MRI is not currently covered by insurance providers and is only available on a “self-pay” basis.

Although studies have demonstrated that fast breast MRI is effective in detecting invasive breast cancers, it is not designed to detect the spectrum of diseases that can be found by a full breast MRI exam. And, as with any screening exam, additional noncancerous lesions that could require biopsy or additional follow-up may also be detected by the fast breast MRI. Mammography is still recommended, and the fast breast MRI study is not meant to replace annual, routine mammograms.

  • Fast breast MRI ordering is available in both the EMR and AEMR. Below is a complete list of updated and simpler MRI codes. Fast MRI is MR 815. Paper ordering is also an option; please specify Fast MRI, MR 815. 
  • MR 805 MRI Breast Bilateral with contrast full protocol
  • MR 803 MRI Breast Bilateral without contrast for implant integrity
  • MR 815 MRI Breast Bilateral with contrast fast Screening (SELF PAY)
  • MR 810 MRI Vacuum Assisted Breast Biopsy

Fast breast MRI is available at:

If you have questions about breast cancer screenings including mammograms, screening ultrasound, fast breast MRI or full breast MRI exams, please contact donna.plecha@uhhospitals.org. The Radiology scheduling line is another resource: 216-844-1700.

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