Screening MRI allows detection of more breast cancers in high-risk women

July 31, 2007

OAK BROOK, Ill. - Magnetic resonance imaging (MRI) enables radiologists to accurately identify tumors missed by mammography and ultrasound, according to a multicenter study comparing the three screening methods in women at high-risk for breast cancer. The findings of the study appear in the August issue of the journal Radiology.

"Women at high risk for breast cancer can benefit from undergoing screening MRI," said the study's lead author, Constance Dobbins Lehman, M.D., Ph.D., professor of radiology at the University of Washington School of Medicine and director of breast imaging at the Seattle Cancer Care Alliance. "Of all the breast imaging tools we have currently available, MRI is clearly the best at detecting cancer."

According to the National Cancer Institute, genetic predisposition accounts for five to 10 percent of all breast cancers. Women who are genetically at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, women below age 50 are more likely to have dense breast tissue, which can limit the effectiveness of mammography as a screening tool. The American Cancer Society recommends that women with a high risk of developing breast cancer should be screened with MRI in addition to their yearly mammogram beginning at age 30.

"It is frightening to be told that you're at very high risk for developing breast cancer," Dr. Lehman said. "It's important that these women understand that there is something they can do to increase their chances of early detection in the event that they do develop breast cancer."

For this study, researchers at six facilities studied 171 asymptomatic women over age 25 (average age 46) with at least a 20 percent lifetime risk of developing breast cancer to compare screening performance of MRI and mammography in high-risk patients. Each of the women underwent MRI, mammography and ultrasound.

Sixteen biopsies were performed, and six cancers were detected for an overall cancer yield of 3.5 percent. All six of the cancers were detected with MRI, while two cancers were detected with mammography and only one cancer was detected with ultrasound. The four cancers found in women with dense breast tissue were only detected with MRI. Biopsy rates were 8.2 percent for MRI and 2.3 percent for mammography and ultrasound. The positive predictive value (PPV) of biopsies performed as a result of MRI findings was 43 percent.

Based on these findings, the researchers estimate that, compared to mammography and ultrasound, screening with MRI will allow detection of 23 more cancers per 1,000 high-risk women screened.

While MRI has been shown to be an effective screening tool for women genetically predisposed to developing breast cancer, there is no evidence to support MRI screening in average-risk women. "Although MRI is a very powerful tool for detecting cancer, it is not perfect," Dr. Lehman cautioned. "There are benign areas of breast tissue that can look suspicious but do not represent breast cancer and yet may lead to a biopsy."
-end-
Journal attribution required.

Radiology is a monthly scientific journal devoted to clinical radiology and allied sciences. The journal is edited by Anthony V. Proto, M.D., School of Medicine, Virginia Commonwealth University, Richmond, Va. Radiology is owned and published by the Radiological Society of North America, Inc. (RSNA.org/radiologyjnl)

The Radiological Society of North America (RSNA) is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

"Cancer Yield of Mammography, MRI, and Ultrasound in High Risk Women: Prospective Multi-institution Breast Cancer Screening Study." Co-authors of the paper are Thomas Claudine Isaacs, M.D., Mitchell D. Schnall, MD, Ph.D., Etta Pisano, M.D., Susan M. Ascher, M.D., Paul T. Weatherall, M.D., David A. Bluemke, M.D., Ph.D., Deborah J. Bowen, Ph.D., P. Kelly Marcom, M.D., Deborah K. Armstrong, M.D., Susan M. Domchek, M.D., Gail Tomlinson, M.D., Ph.D., Steven Skates, Ph.D., Constantine Gatsonis, Ph.D.

This study was funded by the International Breast MRI Consortium and the Cancer Genetics Network.

Radiological Society of North America

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.