Many women willing to pay out-of-pocket for advanced breast imaging: study

por John R. Fischer, Senior Reporter | April 20, 2021
MRI Women's Health
More women are willing to pay out of pocket for advanced breast imaging to rule out breast cancer
Most women are opting for advanced breast imaging exams — even if it means paying out-of-pocket.

That’s what researchers at Beth Israel Deaconess Medical Center and Harvard Medical School found in a new study, which shows most women — especially ones with dense breasts — are unsatisfied with only undergoing mammography for breast cancer assessment.

They also do not appear to be concerned with the risks involved with breast MR and contrast-enhanced mammography (CEM), including adverse contrast reactions, false positives and unnecessary biopsies.
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“Prior to our study, little was known about whether asymptomatic patients in the general screening population would accept the associated downsides and risks related to contrast-enhanced imaging, despite improved cancer detection, compared to conventional mammography,” wrote Dr. Daniel Son and co-authors, with the division of breast imaging at Beth Israel Deaconess Medical Center and Harvard Medical School.

Out of nearly 1,000 patients scheduled at a single institute for a mammogram, only 34.7% said they were satisfied with their breast screening plan. More than half said they would pay $250-$500 for an MR exam, especially if they had dense breasts. A further 10.3% with dense breasts indicated they would pay $500-$1,000.

A majority was not concerned with CEM radiation exposure (70.3%), contrast reaction (75.4%), IV line placement (82.2%), claustrophobia (67.4%), and false positives (70.7%). Those with a prior breast MR or CEM exam were less concerned about allergic reactions, IV and claustrophobia.

More than half had dense breast tissue, and out of this group, 49.6% were called back, 29% had a benign biopsy and 13.7% had a prior CEM/MR exam. Those with a previous benign biopsy or MR/CEM exam were not as worried about false positives.

Dr. Stamatia Destounis, director of clinical research at mammography practice Elizabeth Wende Breast Care, who was not involved in the study, told HCB News that while interesting, more research is needed. "I wonder if in this survey we have a somewhat biased group of women from one institution only, that have a high number of callbacks and benign biopsies, do not trust mammography only and are already knowledgeable about contrast enhanced studies. I believe a multi-institutional study or survey would be helpful to validate these results."

While supplemental imaging is desired, breast MR is limited by high costs and low availability, while CEM is new and requires radiation. Mammography is still considered the gold standard for screening, according to the authors.

The findings were published in Academic Radiology.

Stacey Harrison

3D Ultrasound imaging

April 21, 2021 11:16

This is very encouraging to see that women are demanding a better experience for breast imaging. QT Ultrasound attempted to offer their comfortable, compression-free breast imaging to women in a luxurious setting through the direct-to-consumer brand, QT breasthealth. Unfortunately, the concept did not prove to be accepted by enough women.
We all need to demand that our healthcare providers advance technology for women - not just for reducing costs, but to improve the experience. Radiation and compression should not be the only first option.

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David Georges

re: 3D Ultrasound imaging

June 03, 2021 10:34

Finally, women will soon have access to the latest technology in breast imaging. Non compression, low dose, true 3D breast CT. FDA has cleared the device for both diagnostic breast imaging and 3D guided biopsy. Three Koning non compression breast imaging devices have already been installed in the US and AMA awarded 6 dedicated CPT codes for breast CT.
This technology initiates the most impactful and positive change to breast imaging in decades.

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