MRI breast screening in high-risk women: cancer detection and survival analysis.
Authors
Evans, D Gareth RKesavan, N
Lim, Y
Gadde, S
Hurley, E
Massat, N
Maxwell, A J
Ingham, S
Eeles, R
Leach, M O
Howell, Anthony
Duffy, S
Affiliation
Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, Manchester, M23 9LT, UK.Issue Date
2014-06
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Show full item recordAbstract
Women with a genetic predisposition to breast cancer tend to develop the disease at a younger age with denser breasts making mammography screening less effective. The introduction of magnetic resonance imaging (MRI) for familial breast cancer screening programs in recent years was intended to improve outcomes in these women. We aimed to assess whether introduction of MRI surveillance improves 5- and 10-year survival of high-risk women and determine the accuracy of MRI breast cancer detection compared with mammography-only or no enhanced surveillance and compare size and pathology of cancers detected in women screened with MRI + mammography and mammography only. We used data from two prospective studies where asymptomatic women with a very high breast cancer risk were screened by either mammography alone or with MRI also compared with BRCA1/2 carriers with no intensive surveillance. 63 cancers were detected in women receiving MRI + mammography and 76 in women receiving mammography only. Sensitivity of MRI + mammography was 93 % with 63 % specificity. Fewer cancers detected on MRI were lymph node positive compared to mammography/no additional screening. There were no differences in 10-year survival between the MRI + mammography and mammography-only groups, but survival was significantly higher in the MRI-screened group (95.3 %) compared to no intensive screening (73.7 %; p = 0.002). There were no deaths among the 21 BRCA2 carriers receiving MRI. There appears to be benefit from screening with MRI, particularly in BRCA2 carriers. Extended follow-up of larger numbers of high-risk women is required to assess long-term survival.Citation
MRI breast screening in high-risk women: cancer detection and survival analysis. 2014, 145 (3):663-72 Breast Cancer Res TreatJournal
Breast Cancer Research and TreatmentDOI
10.1007/s10549-014-2931-9PubMed ID
24687378Type
ArticleLanguage
enISSN
1573-7217ae974a485f413a2113503eed53cd6c53
10.1007/s10549-014-2931-9
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