MRI as an Adjunct to Conventional Mamomography Screening for Cancer in Dense Breast Tissue

February, 2015  As Chair of the Walden University Faculty Dissertation Committee, I am pleased to present the Abstract prepared by Rachel S. Connett, Ph.D. in Health Services.  Dr. Marilyn Simon served as her Committee Member.

Abstract

 Diagnostic methods to effectively image dense breast tissue (DBT) can pose challenges. While conventional mammography is the gold standard for breast cancer screening, conventional mammography can miss about 78% of cancers in DBT and ultrasonography can miss 24% or produce false positive results. Magnetic resonance imaging (MRI) has a high sensitivity for imaging DBT and produces a smaller number of false positives, but MRI is used to image only women with an elevated threat of breast cancer; it is not routine for this population. The purpose of this study was to determine to what extent conventional mammograms can miss breast cancer in women with DBT and to determine if an adjunct method of imaging DBT might detect breast cancers that are missed by mammography alone. This mixed methods study was based on the theoretical framework of von Bertalanffy’s general systems theory, Miller’s living systems theory, and the theory of intelligent medical diagnosis. Key research inquiries were as follows: (a) Can MRI can be used for screening women with DBT as an adjunct to conventional mammography? (b) What were the lived experiences of women with breast cancer in DBT prior to and after the breast cancer diagnosis? Key results showed that (a) a significant number of women with DBT had breast cancer that was undetected by mammograms; (b) women with DBT can benefit from breast cancer screening by adding an adjunct screening method (MRI or ultrasonography). This study may contribute to social change by making the breast cancer screening community aware of the potential benefit of adding MRI as an adjunct to conventional screening so that more breast cancers are detected in the early stages of the disease.