✦ LIBER ✦

Screening women at high risk for breast cancer with mammography and magnetic resonance imaging

✍ Scribed by Constance D. Lehman; Jeffrey D. Blume; Paul Weatherall; David Thickman; Nola Hylton; Ellen Warner; Etta Pisano; Stuart J. Schnitt; Constantine Gatsonis; Mitchell Schnall; for the International Breast MRI Consortium Working Group

Publisher: John Wiley and Sons
Year: 2005
Tongue: English
Weight: 112 KB
Volume: 103
Category: Article
ISSN: 0008-543X
DOI: 10.1002/cncr.20971

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

BACKGROUND

The authors compared the performance of screening mammography versus magnetic resonance imaging (MRI) in women at genetically high risk for breast cancer.

METHODS

The authors conducted an international prospective study of screening mammography and MRI in asymptomatic, genetically high‐risk women age ≥ 25 years. Women with a history of breast cancer were eligible for a contralateral screening if they had been diagnosed within 5 years or a bilateral screening if they had been diagnosed > 5 years previously. All examinations (MRI, mammography, and clinical breast examination [CBE]) were performed within 90 days of each other.

RESULTS

In total, 390 eligible women were enrolled by 13 sites, and 367 women completed all study examinations. Imaging evaluations recommended 38 biopsies, and 27 biopsies were performed, resulting in 4 cancers diagnosed for an overall 1.1% cancer yield (95% confidence interval [95%CI], 0.3–2.8%). MRI detected all four cancers, whereas mammography detected one cancer. The diagnostic yield of mammography was 0.3% (95%CI, 0.01–1.5%). The yield of cancer by MRI alone was 0.8% (95%CI, − 0.3–2.0%). The biopsy recommendation rates for MRI and mammography were 8.5% (95%CI, 5.8–11.8%) and 2.2% (95%CI, 0.1–4.3%).

CONCLUSIONS

Screening MRI in high‐risk women was capable of detecting mammographically and clinically occult breast cancer. Screening MRI resulted in 22 of 367 of women (6%) who had negative mammogram and negative CBE examinations undergoing biopsy, resulting in 3 additional cancers detected. MRI also resulted in 19 (5%) false‐positive outcomes, which resulted in benign biopsies. Cancer 2005. © 2005 American Cancer Society.

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