Non Peer Reviewed
Magnetic resonance imaging: an acceptable way of screening women with a family history of breast cancer?
J. Anderson <[email]>
L. G. Walker <[email]>
M. O. Leach <[email]>
Background: Magnetic Resonance Imaging (MRI) may be a good way of detecting small tumours in younger women at genetic risk of breast cancer. However, there is concern that annual MRI would cause significant distress. Within the context of a multicentre, MRC-funded study, a 5-year study to compare the acceptability of breast MRI and two-view X-Ray Mammography (XRM) was undertaken.
Method:Women aged 25-50 at genetic risk of breast cancer were recruited continuously over 5 years. They attended annually for MRI and XRM. Psychological assessments were made: four weeks before; immediately before; immediately after; and six weeks after each scan.
Results: 616 women attended for year-1 scans, 411 returned in year-2, 261 in year-3, 160 in year-4, and 49 in year-5. Mean age of women recruited was 40.7 years (range 24-50). Response rates ranged from 71.3% (pre-XRM) to 91.2% (post-MRI). In year 1, the vast majority of women rated MRI and XRM as “not at all” or “a little” distressing (86.5% and 92.2% respectively). 13.5% of women rated MRI, and 7.8% rated XRM, as “extremely”, “very” or “moderately” distressing. Women were significantly more anxious (Spielberger State Anxiety Inventory: t=2.63, p=0.009) before MRI than before XRM. Six weeks after the scans, levels of intrusive thoughts about MRI, and total subjective MRI-related distress (Impact of Events Scale) were significantly greater than intrusive thoughts about XRM (t=6.38, p<0.000), or total subjective XRM-related distress (t=3.94, p<0.000).
Conclusion: MRI may be a good way of screening women with a family history of breast cancer. Although the majority find the procedure acceptable, some women find MRI significantly distressing and this distress can persist for at least six weeks. These results inform optimal management of women with a family history and suggest the need for psychosocial support that is both timely and appropriate.