ASPO Abstracts
Frequency and Predictors of Screening Breast MRI during the COVID-19 Pandemic: A Retrospective, Chart-Review Study
Category: Early Detection & Risk Prediction
Conference Year: 2023
Abstract Body:
Purpose: The COVID-19 pandemic affected cancer screening. This study examined frequency and demographic/clinical predictors of screening breast MRI during the COVID-19 pandemic. Methods: Retrospective electronic medical record (EMR) review identified breast imaging encounters (screening mammogram or breast MRI) between March 13– December 31 in 2019 or 2020 for female patients ages 18-85. To identify and remove diagnostic breast MRIs from our analytic sample, members of the study team reviewed breast MRI orders for diagnostic indications (e.g., implant rupture, breast complaint, etc.). We also excluded participants with a diagnosis of in situ or invasive breast cancer within 5 years of the imaging procedure. First, a logistic regression model with generalized estimating equations examined whether timing of visit (pre- COVID=0, during COVID=1) was associated with receipt of breast MRI (yes=1, no=0). Then, exact logistic regression models examined whether demographic (i.e., age, race, ethnicity, insurance status) and clinical (i.e., family history of breast cancer) factors were associated with receipt of breast MRI during COVID (yes=1, no=0) among participants who had received a breast MRI pre-COVID. Results: Data included 30,106 visits from 24,128 unique patients (1-3 visits/patient). Our institution averaged 19 screening breast MRIs per month in 2019 and 8 screening breast MRIs per month in 2020. Odds of having a screening breast MRI were significantly lower during COVID (OR=0.76 [0.61, 0.94], p=0.011). Of the 179 patients who had received a screening breast MRI pre-COVID, only 15 (8%) also had a screening breast MRI during COVID. No demographic or clinical factors were significantly associated with receipt of screening breast MRI during COVID (all p's>0.37). Conclusion: Consistent with prior studies on screening mammogram, rates of screening breast MRI decreased during the COVID-19 pandemic. Unlike screening mammogram, supplemental breast MRI did not demonstrate a "rebound
Keywords: breast cancer; screening; magnetic resonance imaging (MRI); COVID-19; electronic medical record