Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Eur Radiol. 2024 Oct;34(10):6334-6347. doi: 10.1007/s00330-024-10685-9. Epub 2024 Apr 19.
Supplemental MRI screening improves early breast cancer detection and reduces interval cancers in women with extremely dense breasts in a cost-effective way. Recently, the European Society of Breast Imaging recommended offering MRI screening to women with extremely dense breasts, but the debate on whether to implement it in breast cancer screening programs is ongoing. Insight into the participant experience and willingness to re-attend is important for this discussion.
We calculated the re-attendance rates of the second and third MRI screening rounds of the DENSE trial. Moreover, we calculated age-adjusted odds ratios (ORs) to study the association between characteristics and re-attendance. Women who discontinued MRI screening were asked to provide one or more reasons for this.
The re-attendance rates were 81.3% (3458/4252) and 85.2% (2693/3160) in the second and third MRI screening round, respectively. A high age (> 65 years), a very low BMI, lower education, not being employed, smoking, and no alcohol consumption were correlated with lower re-attendance rates. Moderate or high levels of pain, discomfort, or anxiety experienced during the previous MRI screening round were correlated with lower re-attendance rates. Finally, a plurality of women mentioned an examination-related inconvenience as a reason to discontinue screening (39.1% and 34.8% in the second and third screening round, respectively).
The willingness of women with dense breasts to re-attend an ongoing MRI screening study is high. However, emphasis should be placed on improving the MRI experience to increase the re-attendance rate if widespread supplemental MRI screening is implemented.
For many women, MRI is an acceptable screening method, as re-attendance rates were high - even for screening in a clinical trial setting. To further enhance the (re-)attendance rate, one possible approach could be improving the overall MRI experience.
• The willingness to re-attend in an ongoing MRI screening study is high. • Pain, discomfort, and anxiety in the previous MRI screening round were related to lower re-attendance rates. • Emphasis should be placed on improving MRI experience to increase the re-attendance rate in supplemental MRI screening.
补充 MRI 筛查以经济有效的方式提高了致密型乳腺女性的早期乳腺癌检出率并降低了间期癌。最近，欧洲乳腺影像学会建议对致密型乳腺女性提供 MRI 筛查，但在乳腺癌筛查项目中是否实施该筛查仍存在争议。了解参与者的体验和再次参与的意愿对于该讨论很重要。
我们计算了 DENSE 试验的第二轮和第三轮 MRI 筛查的再次就诊率。此外，我们计算了年龄调整后的优势比（OR），以研究特征与再次就诊之间的关联。停止 MRI 筛查的女性被要求提供一个或多个停止的原因。
第二轮和第三轮 MRI 筛查的再次就诊率分别为 81.3%（3458/4252）和 85.2%（2693/3160）。高龄（>65 岁）、极低的 BMI、较低的教育程度、未就业、吸烟和不饮酒与较低的再次就诊率相关。在之前的 MRI 筛查轮次中经历中度或高度疼痛、不适或焦虑与较低的再次就诊率相关。最后，许多女性提到检查相关的不便作为停止筛查的原因（第二轮和第三轮筛查分别为 39.1%和 34.8%）。
致密型乳腺女性再次参加正在进行的 MRI 筛查研究的意愿很高。然而，如果广泛实施补充性 MRI 筛查，则应强调改善 MRI 体验以提高再次就诊率。
对于许多女性来说，MRI 是一种可接受的筛查方法，因为即使在临床试验环境下，再次就诊率也很高。为了进一步提高（再次）就诊率，一种可能的方法是改善整体 MRI 体验。
参加正在进行的 MRI 筛查研究的意愿很高。
在前一轮 MRI 筛查中出现的疼痛、不适和焦虑与较低的再次就诊率相关。
应强调改善 MRI 体验，以提高补充性 MRI 筛查的再次就诊率。
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