RICHMOND, Va. - As the owner of an interior design business in Richmond for 20 years, Karen Hardy knows attention to detail is important. So she said she did not hesitate in 2010 when her doctor recommended a breast MRI, an even more detailed screening test because she had been diagnosed with breast cancer back in 2005.
"Whatever you tell me to do, I'm going to do it,” Hardy recalled saying about her doctor's recommendation.
The MRI is considered to be more sensitive, picking up abnormalities sometimes missed on a mammogram.
Hardy had four breast MRIs in four years, all of them clear. But this year, she said she decided not to have the test. She called it grueling.
"Uncomfortable may be an understatement, " Hardy said . "You have to lie completely still for at least 40 minutes."
While Hardy felt she did not need an MRI this year, some women who may want one have run into difficulties. That's because health insurance companies are making it harder for women who are not at high risk for breast cancer to get a screening MRI, according to Dr. Misti Wilson with the Bon Secours Virginia Breast Center.
Two large studies found an increased use of the test in the past decade among women considered at average risk for breast cancer.
A woman can be considered at high risk for breast cancer if:
- she has a strong family history of breast and or ovarian cancer
- she had previous abnormal breast biopsies
- she carries the breast cancer gene
- she has a previous history of chest radiation
- she is of Ashkenazi Jewish descent, which is known for having hereditary cancers
Using these criteria, if your doctor determined your risk for breast cancer is 20 percent or higher and you're 30 years old or older, you are considered high risk.
"You have to be careful and not use it on everybody," Dr. Wilson said.
The concern, according to Wilson, is unnecessary biopsies and cost.
The average cost of a mammogram is $800. The average coast of a screening MRI is $4,500.
"I think women need to know that just because the MRI is there does not mean that it is the best test for everyone," Wilson said.
With her focus on the details of both her business and her health, Hardy said she was confident her decision not to have a breast MRI this year is the right one. She urged other women to understand their choices.
"If they don't give you true reasons other than it may detect breast cancer, well, so will a mammogram," Hardy said.
Talk to your doctor about your screening options and know which tests your health insurance company will cover.