Why don’t all women with extremely dense breasts want MRI screening?

Excerpt

The Dutch Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial provides important evidence of the benefit of adding biennial screening contrast-enhanced breast MRI after negative mammography in women with extremely dense breasts aged 50–74. In the first year, among 4783 women who had MRI, 79 (16.5/1000) were found to have cancer on MRI, and 375/4700 (8.0%) women experienced a false-positive recall. In the second round, among 3436 women who had an MRI, 20 (5.8/1000) were found to have cancer on MRI, and 90/3416 (2.6%) women experienced a false-positive recall [1]. Of 99 cancers seen on MRI, 78 (79%) were invasive. In the first round, 55/64 (86%) invasive cancers seen on MRI were node-negative, and in the second round, all 20 cancers were node-negative and early stage. Symptomatic interval cancers were greatly reduced among women participating in prevalence MRI screening, at 4/4783 (0.8/1000) vs. 16/3278 (4.9/1000) among those invited to MRI but not participating [2]. …