Breast magnetic resonance imaging as a problem solving tool in women recalled at biennial screening mammography: A population-based study in the Netherlands |
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| Affiliation: | 1. Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands;2. Department of Epidemiology, Maastricht University Medical Center, Universiteitssingel 60, 6229, ER, Maastricht, the Netherlands;3. Department of Research and Development, Netherlands Comprehensive Cancer Organization, Godebaldkwartier 419, 3511, DT, Utrecht, the Netherlands;4. Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands;5. Dutch Expert Center for Screening, Wijchenseweg 101, 6538, SW, Nijmegen, the Netherlands;6. Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223, GZ, ‘s-Hertogenbosch, the Netherlands;7. Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532, SZ, Nijmegen, the Netherlands;8. Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623, EJ, Eindhoven, the Netherlands;9. Department of Radiology, Maxima Medical Center, De Run 4600, 5504, MB, Veldhoven, the Netherlands;10. Department of Radiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, the Netherlands;11. Department of Radiology, Canisius Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, the Netherlands |
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| Abstract: | 
PurposeProblem solving magnetic resonance imaging (MRI) is used to exclude malignancy in women with equivocal findings on conventional imaging. However, recommendations on its use for women recalled after screening are lacking. This study evaluates the impact of problem solving MRI on diagnostic workup among women recalled from the Dutch screening program, as well as time trends and inter-hospital variation in its use.MethodsWomen who were recalled at screening mammography in the South of the Netherlands (2008–2017) were included. Two-year follow-up data were collected. Diagnostic-workup and accuracy of problem solving MRI were evaluated and time trends and inter-hospital variation in its use were examined.ResultsIn the study period 16,175 women were recalled, of whom 906 underwent problem solving MRI. Almost half of the women (45.4%) who underwent problem solving MRI were referred back to the screening program without further workup. The sensitivity, specificity, and positive and negative predictive values of problem solving MRI were 98.2%, 70.0%, 31.1%, and 99.6%, respectively. The percentage of recalled women receiving problem solving MRI fluctuated over time (4.7%–7.2%) and significantly varied among hospitals (2.2%–7.0%).ConclusionThe use of problem solving MRI may exclude malignancy in recalled women. The use of problem solving MRI varied over time and among hospitals, which indicates the need for guidelines on problem solving MRI. |
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| Keywords: | Breast neoplasms Early detection of cancer Magnetic resonance imaging Problem solving |
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