The use of MRI screening in the population screening programme for breast cancer
Mammograms show that just under 10% of women between the ages of 50 and 75 who participate in the population screening programme for breast cancer have extremely dense breast tissue (fibroglandular tissue). Not only are they at greater risk of developing breast cancer, but any tumours are less visible on their mammograms. The DENSE study explored the use of supplemental MRI screening within the population screening programme, to show whether this might benefit such women. In response to this, the State Secretary for Health, Welfare and Sport asked the Health Council of the Netherlands whether it would be appropriate to include supplemental MRI screening in the population screening programme.
The study’s results show that a supplemental MRI screening can indeed detect more tumours. However, that method also involves significant drawbacks. Another method for detecting tumours in extremely dense breast tissue is contrast-enhanced mammography (CEM). The balance between the benefits and drawbacks of that method still needs to be investigated in the context of a population screening programme. Studies in women with suspected or confirmed breast cancer have produced promising results. Before too long, CEM is expected to provide a more suitable alternative. Thus, the Health Council of the Netherlands does not feel that supplemental MRI in the population screening programme for breast cancer would be future-proof. Accordingly, the Council advises against investing in MRI screening at the present time. Instead, trial screening with CEM should first be studied.