Abbreviated MRI Screening in Turkish Women Aged 40-69 With Dense Breasts: A Prospective Feasibility Study

Abstract

Introduction We aimed to investigate the feasibility of abbreviated protocol (AP) breast magnetic resonance imaging (MRI) screening in women with dense breasts in a screening program in a middle-income country.Methods This prospective study included 649 women selected randomly from 1285 women with type C and D breasts in a screening program, of which 238 underwent an abbreviated breast MRI screening (AP-MRI). The AP-MRI consisted of dynamic series during the first and second post-contrast phases, in addition to axial T1W and axial T2W-fat sat (TRIM) sequences. The reference standard for the study was based on pathology results obtained from biopsies and normal screening mammography results within two years.Results MRI scans of 201 women (84.4%) displayed normal or benign findings (BIRADS-1 and 2). An additional 25 women (10.5%) were recommended for MRI or ultrasound (USG) follow-up (BI-RADS-3) and did not show any progression in the two-year follow-up. The remaining 12 women (5%) were recommended a biopsy (BIRADS-4), of which five were reclassified as BIRADS-3 after a second-look ultrasound. Subsequently, a biopsy of the remaining seven patients did not reveal any malignancies. They all had a negative two-year follow-up. The main challenges encountered were scheduling AP-MRI screening and compliance of women.Conclusion In this small, single-center cohort of women with dense breasts, supplemental AP MRI screening did not identify additional cancers and was associated with false-positive findings that could lead to overdiagnosis and unnecessary biopsies. Larger, prospective, multicenter studies are needed to clarify the role of AP MRI in breast cancer screening and to determine its optimal integration into existing screening programs.