Patient preferences regarding use of contrast-enhanced imaging for breast cancer screening

Rationale and Objectives: Our purpose is to understand patient preferences towards contrast-enhanced imaging such as CEM or MRI for breast cancer screening. Methods and Materials: An anonymous survey was offered to all patients having screening mammography at a single academic institution from December 27 th 2019 to March 6th 2020. Survey questions related to: (1) patients' background experiences (2) patients' concern for aspects of MR and CEM measured using a 5-point Likert scale, and (3) financial considerations. Results: 75% (1011/1349) patients completed the survey. 53.0% reported dense breasts and of those, 47.6% had additional screening. 49.6% had experienced a callback, 29.0% had a benign biopsy, and 13.7% had prior CEM/MRI. 34.7% were satisfied with mammography for screening. A majority were neutral or not concerned with radiation exposure, contrast allergy, IV line placement, claustrophobia, and false positive exams. 54.7% were willing to pay at least $250-500 for screening MRI. Those reporting dense breasts were less satisfied with mammography for screening (p <0.001) and willing to pay more for MRI (p <0.001). If patients had prior CEM/MRI, there was less concern for an allergic reaction (p < 0.001), IV placement (p = 0.025), and claustrophobia (p = 0.006). There was less concern for false positives if they had a prior benign biopsy (p = 0.029) or prior CEM/MRI (p = 0.005) and less concern for IV placement if they had dense breasts (p = 0.007) or a previous callback (p = 0.013). Conclusion: The screening population may accept CEM or MRI as a screening exam despite its risks and cost, especially patients with dense breasts and patients who have had prior CEM/MRI.

Automated summary

The study aimed to gain understanding of patient preferences towards contrast-enhanced imaging such as CEM or MRI for breast cancer screening. An anonymous survey was conducted among patients undergoing screening mammography at a single academic institution. Results showed that a significant proportion of patients with dense breasts and prior CEM/MRI were willing to accept the risks and costs associated with CEM or MRI as a screening exam. Concerns related to aspects of the imaging procedure varied among patients.