Breast MRI as an Adjunct to Mammography for Breast Cancer Screening in High-Risk Patients: Retrospective Review

Raikhlin, Antony; Curpen, Belinda; Warner, Ellen; Betel, Carrie; Wright, Barbara; Jong, Roberta A.

doi:10.2214/ajr.13.12264

Cited by 52 publications

(39 citation statements)

References 41 publications

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“…The authors also found an added cancer detection rate of 1.3% with MRI alone, which translates to 13 additional cancers detected per 1,000 screening MRI examinations performed. 45 A 2015 report by Raikhlin et al 47 documented detecting an additional 10 cancers per 1,000 patients screened with MRI and mammography together vs mammography alone.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…When MRI was added to mammography, Warner et al 46 and Sardanelli et al 44 found that the specificity rates decreased from 99% to 95% and 96%, respectively. Raikhlin et al 47 reported a specificity rate of 86% for MRI of the breast with associated callback rates nearly 10 times higher and biopsy rates nearly 5 times higher than with mammography alone. Schwartz et al 56 concluded that the positive predictive value of 20% and the increased callback rate of 24% may not justify MRI screening in the population they studied for the added cancer detection rate of 2%.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…The results from studies show that the benefits of MRI typically outweigh the limitations among patients with an estimated lifetime risk of breast cancer of higher than 20%. 28,[40][41][42][43][44][45][46][47] As new data become available, additional indications may emerge. In the meantime, no clear indication exists for performing screening MRI in patients with dense breasts, and the recommended use of screening MRI in this population should be the same as that for the general population based on personal risk.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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“…43 In females having hereditary history of breast cancer (BRCA I/II mutation) MRI with mammography is helpful. 44 …”

Section: Screening For Breast Cancermentioning

confidence: 99%

Is It Possible to Reduce Cancer Burden in India?

Khargekar¹

2017

jmscr

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“…MRI has demonstrated an incremental detection rate of 9.5 cancers per 1,000 high-risk women screened (7) and variable sensitivity and specificity ranging from 71% to 92% and 54% to 86%, respectively (8)(9)(10). However, MRI is costly, time-consuming for radiologists to interpret, poorly tolerated by some patients due to claustrophobia, and inaccessible to patients who are obese, have implanted devices, or have renal insufficiency.…”

mentioning

confidence: 99%

Breast-Specific γ-Imaging for the Detection of Mammographically Occult Breast Cancer in Women at Increased Risk

et al. 2016

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Breast-specific γ-imaging (BSGI) is a physiologic imaging modality that can detect subcentimeter and mammographically occult breast cancer, with a sensitivity and specificity comparable to MRI. The purpose of this study was to determine the incremental increase in breast cancer detection when BSGI is used as an adjunct to mammography in women at increased risk for breast cancer. Methods: All patients undergoing BSGI from April 2010 through January 2014 were retrospectively reviewed. Eligible patients were identified as women at increased risk for breast cancer and whose most recent mammogram was benign. Examinations exhibiting focally increased radiotracer uptake were considered positive. Incremental increase in cancer detection was calculated as the percentage of mammographically occult BSGI-detected breast cancer and the number of mammographically occult breast cancers detected per 1,000 women screened. Results: Included in this study were 849 patients in whom 14 BSGI examinations detected mammographically occult breast cancer. Patients ranged in age from 26 to 83 y, with a mean age of 57 y. Eleven of 14 cancers were detected in women with dense breasts. The addition of BSGI to the annual breast screen of asymptomatic women at increased risk for breast cancer yields 16.5 cancers per 1,000 women screened. When high-risk lesions and cancers were combined, BSGI detected 33.0 high-risk lesions and cancers per 1,000 women screened. Conclusion: BSGI is a reliable adjunct modality to screening mammography that increases breast cancer detection by 1.7% (14/849) in women at increased risk for breast cancer, comparable to results reported for breast MRI. BSGI is beneficial in breast cancer detection in women at increased risk, particularly in those with dense breasts. Br east cancer is the second most common cancer in American women (1). X-ray mammography remains the standard of breast cancer screening and is an effective imaging tool that reduces mortality from breast cancer (2). However, it is an imperfect tool, with an overall reported sensitivity of 85%, which decreases to 68% in women with dense breasts (3,4). In prospective trials among women at high risk for breast cancer due to a familial or genetic predisposition, mammography demonstrated a 30%-40% sensitivity (5). Because of the limitations of mammography, supplemental imaging modalities, including MRI, whole-breast screening ultrasound, and breast-specific g-imaging (BSGI), are becoming increasingly important for women at increased risk, with the goal of detecting early-stage breast cancer.Breast MRI is a physiologic imaging modality recommended as a supplemental screening tool to mammography for high-risk women ($20%-25% lifetime risk) (6). MRI has demonstrated an incremental detection rate of 9.5 cancers per 1,000 high-risk women screened (7) and variable sensitivity and specificity ranging from 71% to 92% and 54% to 86%, respectively (8-10). However, MRI is costly, time-consuming for radiologists to interpret, poorly tolerated by some patients due to claus...

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Breast MRI as an Adjunct to Mammography for Breast Cancer Screening in High-Risk Patients: Retrospective Review

Abstract: MRI is a useful adjunct to mammography for screening in high-risk women, resulting in a significantly higher rate of cancer detection. However, this was found to be at the cost of more imaging and biopsies for lesions that ultimately proved to be benign.

Cited by 52 publications

References 41 publications

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

Is It Possible to Reduce Cancer Burden in India?

Breast-Specific γ-Imaging for the Detection of Mammographically Occult Breast Cancer in Women at Increased Risk

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