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Screening women at high risk for breast cancer with mammography and magnetic resonance imaging†
Article first published online: 30 MAR 2005
Copyright © 2005 American Cancer Society
Volume 103, Issue 9, pages 1898–1905, 1 May 2005
How to Cite
Lehman, C. D., Blume, J. D., Weatherall, P., Thickman, D., Hylton, N., Warner, E., Pisano, E., Schnitt, S. J., Gatsonis, C., Schnall, M. and for the International Breast MRI Consortium Working Group (2005), Screening women at high risk for breast cancer with mammography and magnetic resonance imaging. Cancer, 103: 1898–1905. doi: 10.1002/cncr.20971
Presented at the annual meeting of the Radiology Society of North America, Chicago, Illinois, November 28–December 3, 2004.
- Issue published online: 18 APR 2005
- Article first published online: 30 MAR 2005
- Manuscript Accepted: 15 DEC 2004
- Manuscript Revised: 13 DEC 2004
- Manuscript Received: 13 OCT 2004
- National Cancer Institute. Grant Numbers: U01 CA 74680, 5 U01 CA74696
- breast cancer;
- magnetic resonance imaging;
- high risk
The authors compared the performance of screening mammography versus magnetic resonance imaging (MRI) in women at genetically high risk for breast cancer.
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.
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%).
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.