Project Funding Details

Magnetic resonance imaging (MRI), a non-invasive imaging test, holds promise for early detection of breast cancer in women at very high risk of breast cancer. In 2007, the American Cancer Society expanded its recommendation for MRI along with routine mammograms for breast cancer screening to women who have at least a 20% lifetime risk of breast cancer. How these guidelines have and will affect the use of screening breast MRI over time is unknown. If followed, these recommendations could cover one to two million women, possibly more depending on how broadly they are applied in practice. Studies have shown that MRI is better at detecting cancer compared with mammograms. However MRI may also lead to additional findings that are not cancer, requiring potentially unnecessary diagnostic testing procedures such as additional mammograms or breast biopsies. In addition it is a more costly test. As screening breast MRI is more widely used, especially following the new clinical guidelines, it will be important to monitor what is occurring in community clinical practice. Monitoring screening breast MRI from evidence to practice will help ensure screening breast MRI is used appropriately and effectively to improve women’s health. The objective of the proposed research is to characterize the use and clinical outcomes of screening breast MRI as it is practiced in the community. This study will examine the use of screening breast MRI in a large medical group practice in Massachusetts from 2000 to the present. Research questions to be addressed are who is using the screening technology and what the test results are from its use. The long-term health effects and total costs of screening breast MRI will be estimated using computer modeling. Computer modeling combined with real world data provides a powerful means to address important and timely questions in cancer prevention and control. Questions about the effects of alternative assumptions about policies or other critical inputs can be easily assessed. From these results, this study will investigate how effectively societal resources are being spent to improve women’s health. Screening breast MRI has the potential to make substantial contributions to cancer control. Because it has only been examined in controlled clinical studies thus far, assessing how well this screening test performs in real-world settings in the community is critical for guiding future policy. This study will be able to investigate if screening breast MRI is used as recommended by the clinical guidelines and can provide insight into how the use may be improved for the future. For women and their doctors, the results will be useful for understanding what happens when participating in a screening breast MRI program. The proposed research will serve as a general framework for evaluating the potential of other screening tests and ensuring their effective implementation into the US health care delivery system.

Magnetic resonance imaging (MRI), a non-invasive imaging test, holds promise for early detection of breast cancer in women at very high risk of breast cancer. In 2007, the American Cancer Society expanded its recommendation for MRI along with routine mammograms for breast cancer screening to women who have at least a 20% lifetime risk of breast cancer. How these guidelines have and will affect the use of screening breast MRI over time is unknown. If followed, these recommendations could cover one to two million women, possibly more depending on how broadly they are applied in practice. Studies have shown that MRI is better at detecting cancer compared with mammograms. However MRI may also lead to additional findings that are not cancer, requiring potentially unnecessary diagnostic testing procedures such as additional mammograms or breast biopsies. In addition it is a more costly test. As screening breast MRI is more widely used, especially following the new clinical guidelines, it will be important to monitor what is occurring in community clinical practice. Monitoring screening breast MRI from evidence to practice will help ensure screening breast MRI is used appropriately and effectively to improve women’s health. The objective of the proposed research is to characterize the use and clinical outcomes of screening breast MRI as it is practiced in the community. This study will examine the use of screening breast MRI in a large medical group practice in Massachusetts from 2000 to the present. Research questions to be addressed are who is using the screening technology and what the test results are from its use. The long-term health effects and total costs of screening breast MRI will be estimated using computer modeling. Computer modeling combined with real world data provides a powerful means to address important and timely questions in cancer prevention and control. Questions about the effects of alternative assumptions about policies or other critical inputs can be easily assessed. From these results, this study will investigate how effectively societal resources are being spent to improve women’s health. Screening breast MRI has the potential to make substantial contributions to cancer control. Because it has only been examined in controlled clinical studies thus far, assessing how well this screening test performs in real-world settings in the community is critical for guiding future policy. This study will be able to investigate if screening breast MRI is used as recommended by the clinical guidelines and can provide insight into how the use may be improved for the future. For women and their doctors, the results will be useful for understanding what happens when participating in a screening breast MRI program. The proposed research will serve as a general framework for evaluating the potential of other screening tests and ensuring their effective implementation into the US health care delivery system.