Fragmented ownership and multilevel barriers to breast MRI screening among high-risk women: A qualitative study informing development of clinical decision support

Background

Women at high risk for breast cancer include those with pathogenic variants in hereditary breast cancer predisposition genes, high-risk benign breast lesions, or a lifetime risk over 20% based on validated models. Supplemental breast MRI screening improves early detection and reduces interval cancers in high-risk women. Despite recommendations from professional organizations for breast MRI screening among high-risk women, uptake remains low. To better understand breast MRI utilization, we conducted a qualitative study exploring healthcare provider and patient perspectives to inform development of a screening module within our patient-facing web-based decision aid, RealRisks.