title: Practicalities of developing a breast magnetic resonance imaging screening service for women at high risk for breast cancer.
abstract: BACKGROUND
  Demand for screening breast magnetic resonance imaging (MRI) for women with a hereditary predisposition to breast cancer has increased since the introduction of a medicare item number. To aid future service planning, we examined the practicalities of establishing and running a breast MRI screening programme for high risk women and to describe the early outcomes of our screening programme.
  
  
  METHODS
  We undertook a retrospective audit of prospectively collected data. Women <50 years of age with an inherited BRCA1 or BRCA2 gene mutation were invited to undergo annual breast screening with MRI in addition to mammography and clinical breast examination. We assessed process times for booking, performing and reporting MRIs; MRI findings and ease of interpretation; patient recall rate; MRI cancer detection rate; and patient satisfaction via questionnaire.
  
  
  RESULTS
  From 2006 to 2009, 82 women completed a round one screening MRI and 45, 21 and one women completed second, third and fourth round annual MRI studies, respectively. Median MRI process times were: booking 20 min; attendance in radiology department 90 min; imaging duration 45 min; reporting by one radiologist 30 min. Of the 82 round one studies, 23 (28%) were reported as ≥Breast Imaging Reporting and Data System three requiring further investigation. Of the round two and three studies completed, 13/45 (28%) and 2/21 (9%) have been recalled, respectively. Seven malignancies were detected. Questionnaires revealed women were satisfied with the service.
  
  
  CONCLUSIONS
  Significant time, staff and equipment is required to run an effective breast MRI screening programme and this must be considered by future service providers.
authors.affiliation: Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia.
authors.forename: Belinda E
authors.initials: BE
authors.lastname: Kiely
authors.forename: Lucinda K
authors.initials: LK
authors.lastname: Hossack
authors.forename: Clair L
authors.initials: CL
authors.lastname: Shadbolt
authors.forename: Anna
authors.initials: A
authors.lastname: Davis
authors.forename: Robin
authors.initials: R
authors.lastname: Cassumbhoy
authors.forename: Kate
authors.initials: K
authors.lastname: Moodie
authors.forename: Yoland
authors.initials: Y
authors.lastname: Antill
authors.forename: Gillian
authors.initials: G
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D014408:Biomarkers, Tumor / Q000235:genetics; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000639:trends*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009154:Mutation; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; D014408:Biomarkers, Tumor