The authors acknowledge the efforts of Cynthia Olson from the American College of Radiology (ACR) in project management, Sophia Sabina and Robert Sole from ACR in data management, Ben Herman from Brown in programming the analyses, and Dr. Paul Stomper for his participation in mammogram Quality Control.
MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883†
Article first published online: 22 SEP 2005
Copyright © 2005 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 92, Issue 1, pages 32–38, 1 October 2005
How to Cite
Schnall, M. D., Blume, J., Bluemke, D. A., DeAngelis, G. A., DeBruhl, N., Harms, S., Heywang-Köbrunner, S. H., Hylton, N., Kuhl, C. K., Pisano, E. D., Causer, P., Schnitt, S. J., Smazal, S. F., Stelling, C. B., Lehman, C., Weatherall, P. T. and Gatsonis, C. A. (2005), MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883. J. Surg. Oncol., 92: 32–38. doi: 10.1002/jso.20381
- Issue published online: 22 SEP 2005
- Article first published online: 22 SEP 2005
- Manuscript Accepted: 12 AUG 2005
- Manuscript Received: 2 MAR 2005
- National Cancer Institute. Grant Number: UO1-CA74696, UO1-CA74680
- breast cancer;
Prior single institution studies suggest MRI may improve the assessment of the extent of cancer within the breast, and thus reduce the risk of leaving macroscopic disease in the breast following breast conservation therapy. We report on the rate of MRI and mammography detection of foci of distinct incidental cancer in a prospective, multi center trial involving 426 women with confirmed breast cancer at 15 institutions in the US, Canada, and Germany.
Women underwent mammography and MRI prior to biopsy of the suspicious index lesion. Additional incidental lesions (IL) greater than 2 cm from the index lesion that were detected by mammography and MRI were noted and characterized. Biopsy recommendations were associated with ILs given an assessment of suspicious or highly suspicous (BiRads 4 and 5). These assessments were considered a positive test.
MRI had a significantly higher yield of confirmed cancer ILs than mammography (0.18 (95%CI: 0.142–0.214) for MRI versus 0.072 (95%CI: 0.050–0.100) for mammography). The cancer ILs detected by MRI alone appeared to be similar to those detected by mammography with respect to size and histology. The percentage of biopsies of ILs that resulted in a cancer diagnosis was similar between the modalities (MRI 0.72(95%CI: 0.6–0.81); Mammography 0.85 (95%CI: 0.62–0.96))
These results suggest that consideration needs to be given regarding the integration of breast MRI into the pretreatment evaluation of women seeking breast conservation therapy. J. Surg. Oncol. 2005;92:32–38. © 2005 Wiley-Liss, Inc.