Breast imagers offer tips for getting reluctant patients to come in for breast MRI

As Diagnostic Imaging previously mentioned, most women at high risk for breast cancer come in for their breast MRI. However, claustrophobia and reluctant patients still exist. Below breast imagers offer their tips.

For patients who are ambivalent about getting scanned, education is key, said Dr. Constance Lehman, who is director of breast imaging at the Seattle Cancer Care Alliance and vice chair of radiology at the University of Washington in Seattle.

“The ability of MRI to detect cancers in high-risk women vastly outweighs the ability of ultrasound at a significantly reduced risk of a false-positive exam or of an unnecessary biopsy,” she said. “When our patients understand this, they are very motivated to have the MRI.”

It’s also important to educate patients about what to expect during the test and make the experience as pleasant as possible with things such as extra pillows, a warm blanket, music, etc., said Dr. Cherie Kuzmiak, an associate professor of radiology at the Lineberger Comprehensive Cancer Center at the University of North Carolina-Chapel Hill.

The most-cited reason patients refuse MRI is claustrophobia. For a patient for whom claustrophobia is an issue, it’s good for her to discuss premedication with her primary care physician. These patients are usually given anxiolytic medicine such as lorazepam to combat their anxiety, said Dr. Stamatia Destounis, a radiologist at Elizabeth Wende Breast Care (EWBC) in Rochester, NY.

“If the patient has no history of claustrophobia but then gets nervous in the magnet, our nurse will stay with the patient and we can usually calm the patient down,” she said. “We also give the patient a call bell to hold and she can press it if she is having difficulty with the exam.”

Lastly, EWBC has an intercom in the MRI room, so the technologist can talk to the patient and say, “You are doing great, three more minutes,” Destounis said.

Essentially it comes down to communication. A great supportive staff makes patients feel they are being taken care of. And patients who just can’t get through the test are rescheduled and encouraged to talk to their doctors about premedication, she said.