WOMEN with BRCA1/2 germline mutations, a group at high risk of developing breast cancer, are frequently denied access to breast MRI scans, despite medical recommendations for annual screening. This worrisome trend was highlighted in a recent study carried out by researchers in the USA.
This eye-opening research revealed that insurance denials for breast MRI scans could delay the diagnosis of breast abnormalities in this vulnerable population, potentially leading to poorer health outcomes.
Guidelines recommend that women with BRCA1/2 mutations undergo yearly breast MRI and mammography to detect cancer early. However, the study’s findings underscore that these critical screenings are not always approved by insurers.
The research team reviewed data from 682 women with BRCA1/2 germline mutations who were referred for annual breast MRI screenings between 2020 and 2021 at a high-risk breast cancer clinic. Their analysis revealed troubling trends in insurance practices.
Of the participants, 73 women (11%) were denied breast MRI scans. The study also found that women insured through Medicaid experienced the highest denial rates, which increased from 7% in 2020 to 18% in 2021. Those with commercial insurance faced lower but still concerning denial rates of 6% in 2020 and 9% in 2021.
Overall, MRI denials rose significantly from 2020 to 2021 (p = 0.044), and appeals were less likely to succeed in the later year. Among women whose MRI requests were denied, 1% did not undergo any screening. Alarmingly, one patient with ductal carcinoma in situ (DCIS) was denied an MRI before her diagnosis.
“These findings highlight worsening barriers for high-risk patients and increased burdens on healthcare providers to secure approval for necessary tests,” the authors noted.
The study has highlighted without a doubt the urgent need for systemic changes to ensure that women with BRCA mutations receive timely, evidence-based screening to improve outcomes and reduce the burden of advanced disease.
Reference
Gordhandas S et al. Barriers to early detection: insurance denials for breast MRI screening in women with germline BRCA1/2 mutations. Gynecol Oncol. 2025;193:20-3.
