Early detection is key in breast cancer treatment. The American Cancer Society estimates that approximately one in eight women will develop breast cancer over their lifetime. Early detection can save lives.
Mammograms have always been, and continue to be, an excellent screening tool for breast cancer. Generally speaking, women 40 years and older who are at average risk of breast cancer should receive regular mammograms. Insurance covers this service because it is the gold standard for breast cancer screening.
However, no test is perfect. This is especially true for women who have a prior history of breast cancer, dense breasts, or moderate-risk gene mutations breast tissue. For these women, a breast MRI, in addition to a mammogram, may be beneficial.
Diagnostic radiologist James Sutherland, DO, explains Abbreviated Breast MRI (also known as AB-MR or fast MRI), an additional screening option for women at average or intermediate risk for breast cancer, and who want greater peace of mind.
Q. What is the difference between mammography and an MRI?
A. Standard mammography uses X-ray radiation to penetrate the breast tissue and capture differences in tissue density while the breast tissue is compressed. Tomosynthesis mammography is also done with X-rays, but it is more detailed and provides 3D images of the breasts in addition to standard 2D views. This can be especially helpful when imaging dense breasts. MRI, on the other hand, uses magnetic and radio waves to create detailed, cross-sectional images of the tissue. MRI can “see” through dense tissue in a way X-rays cannot creating the clearest view of the breast tissue.
Q. What is the benefit of a clearer/better view with MRI technology?
A. We can better detect masses, especially in dense breast tissue. Also, an intravenous contrast medium used during the scan can highlight non-mass tissue patterns that could indicate underlying cancer, providing an added layer of accuracy and detail to help with early detection of breast cancer.
Q. Is there a risk with the contrast medium?
A. The contrast medium used in Abbreviated Breast MRI is a different substance than what is used in a CT scan. While it has fewer and less severe side effects than the CT contrast, some patients might have a minor reaction to the contrast medium, such as feeling flushed, itchy, or nauseated. The contrast is filtered from the body by the kidneys, and we screen patients for specific risk factors related to kidney function to help ensure a safe procedure.
Q. What is an Abbreviated Breast MRI (AB-MR) and how is it different than a standard breast MRI?
A. An AB-MR, or fast MRI, is an enhanced protocol that takes less than 10 minutes of scan time, compared to 30 minutes for a traditional MRI. Research studies have shown that the abbreviated scan provides very similar diagnostic accuracy as the standard breast MRI. Of course, if something of concern is noted on the scan, additional testing steps may be required.
Q. Who should talk with their doctor about getting a standard breast MRI or an AB-MR?
A. The American Cancer Society recommends both a mammogram and a standard breast MRI for women at a high risk for breast cancer. This includes women with BRCA1 or BRCA2 gene mutations, untested women who have a first-degree family member with a known BRCA1 or BRCA2 mutation, and women with a history of chest radiation between the ages of 10 and 30 are considered high risk and are recommended for annual screening MRI.
In addition, roughly 47% of women in the United States have dense breasts, which is an independent risk factor of breast cancer. Compared to other common supplemental screening methods, breast MRI was superior at detecting breast cancer in women with dense breasts, according to a study published in Radiology.
Q. How often should I have an AB-MR?
A. Since the AB-MR is additional and optional, there are no standard guidelines for screening frequency. One strategy for women who want to invest in extra screening is to have alternating tests every six months. So once per year, they will have a mammogram, and then six months later they will also have an AB-MR.
Q. Does insurance pay for standard breast MRI or AB-MR?
A. A standard breast MRI is covered by insurance when a patient is at high risk or has a known history of breast cancer. The AB-MR is an optional screening for women at average or intermediate risk, so it’s not typically covered by insurance and would be a $500 out-of-pocket investment. It is, however, a medical expense that qualifies for most flex savings accounts (FSA), health savings accounts (HSA), or health reimbursement arrangements (HRA).
An AB-MR requires a provider referral to schedule an appointment.
Learn more about breast cancer screening at Trinity Health Michigan.
If you’re interested in the additional AB-MR screening, talk to your doctor about a referral to a Trinity Health Michigan Breast Care Center.