Patterns of Screening Mammography and Breast MRI During the COVID-19 Pandemic: A Retrospective, Chart-Review Study

Shankarapryan Sivanushanthan; Tianmin Wu; Anastacia Wahl; Tengfei Li; George Luta; Judy H Song; Suzanne O'Neill; Claire C Conley

doi:10.1093/jbi/wbad006

Patterns of Screening Mammography and Breast MRI During the COVID-19 Pandemic: A Retrospective, Chart-Review Study

J Breast Imaging. 2023 Feb 23;5(3):277-286. doi: 10.1093/jbi/wbad006. eCollection 2023 May-Jun.

Authors

Shankarapryan Sivanushanthan¹, Tianmin Wu², Anastacia Wahl¹, Tengfei Li², George Luta², Judy H Song³, Suzanne O'Neill⁴, Claire C Conley⁴

Affiliations

¹ Georgetown University, School of Medicine, Washington, DC, USA.
² Georgetown University, Department of Biostatistics, Bioinformatics, and Biomathematics, Washington, DC, USA.
³ Georgetown University, Department of Radiology, Washington, DC, USA.
⁴ Georgetown University, Department of Oncology, Washington, DC, USA.

Abstract

Objective: This study examined patterns of breast cancer screening during the COVID-19 pandemic.

Methods: This retrospective study was approved by the Georgetown University IRB. Review of electronic medical records identified screening mammograms and breast MRIs between March 13, 2018 and December 31, 2020, for female patients aged 18 to 85 years. Descriptive statistics characterized patterns of breast cancer screening before and during the COVID-19 pandemic. Logistic regression analyses examined whether receipt of breast MRI differed over time and demographic and clinical factors associated with receipt of breast MRI in 2020.

Results: Data included 47 956 mammography visits in 32 778 patients and 407 screening breast MRI visits in 340 patients. After an initial decrease following the declaration of the COVID-19 pandemic, both screening mammograms and screening breast MRI demonstrated early recovery. Although the mammography receipt remained sustained, the receipt of screening breast MRI decreased in late 2020. Odds of having a breast MRI did not differ between 2018 and 2019 (OR = 1.07; 95% CI = 0.92%-1.25%; P = 0.384) but were significantly lower in 2020 versus 2019 (OR = 0.76; 95% CI = 0.61%-0.94%; P = 0.011). No demographic or clinical factors were associated with receipt of breast MRI during the COVID-19 pandemic (all P-values ≥0.225).

Conclusion: Breast cancer screening decreased following the declaration of the COVID-19 pandemic. Although both procedures demonstrated early recovery, the rebound in screening breast MRI was not sustained. Interventions promoting return to screening breast MRI may be needed for high-risk women.

Keywords: COVID-19; breast MRI; breast cancer; family history of breast cancer; high-risk screening; mammography.

Grants and funding

P30 CA051008/CA/NCI NIH HHS/United States