Efficacy of Magnetic Resonance Imaging and Mammography for Breast Cancer Screening in Women With a Familial or Genetic Predisposition

Kriege, Mieke; Brekelmans, C. T. M.; Boetes, C.; Besnard, Peter E.; Zonderland, Harmine M.; Obdeijn, Inge Marie; Manoliu, Radu A.; Kok, Theo M. de; Peterse, Hans; Tilanus-Linhorst, Madeline M. A.; Müller, Sara; Meijer, Sybren; Oosterwijk, Jan C.; Beex, L.V.A.M.; Tollenaar, Rob A.E.M.; Koning, Harry J. de; Rutgers, T.; Klijn, Jan G.M.

doi:10.1097/01.ogx.0000151669.38495.2e

Cited by 55 publications

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“…The biopsy rate of 13.2% is within the range of previously published studies on high-risk screening (4.4-17%) [18,27,28]. There was a trend toward increasing biopsy rate with increasing background enhancement, but this trend did not reach statistical significance.…”

Section: Background Parenchymal Enhancement On Breast Mrisupporting

confidence: 69%

“…The rate of BI-RADS 3 in this study (43.6%) is higher than in other previously published studies (6.6-24%) [15][16][17][18][19][20]. One possible reason for this difference is that many of the other studies reporting a lower short-interval follow-up rate included followup MRI examinations, for which the rate of BI-RADS 3 will be lower than for baseline MRI examinations.…”

Section: Discussioncontrasting

confidence: 55%

“…Previous studies have shown a cancer rate of 0.6-10% in patients with findings initially classified as BI-RADS 3 [15][16][17][18][19][20]. This cancer rate differs from mammography, where, by definition, BI-RADS 3 lesions are associated with a less than 2% malignancy rate [21][22][23].…”

Section: Background Parenchymal Enhancement On Breast Mrimentioning

confidence: 55%

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Background Parenchymal Enhancement on Baseline Screening Breast MRI: Impact on Biopsy Rate and Short-Interval Follow-Up

Hambly

Liberman

Dershaw

et al. 2011

American Journal of Roentgenology

133

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in the breast parenchyma during the menstrual cycle [4][5][6]. Estrogen has been shown to exert a histamine-like effect that causes an increase in microvascular permeability and vasodilation, and progesterone exerts a mitogenic effect that may increase metabolic activity, also resulting in an increase in perfusion [7,8].The detection of malignancy at MRI is based on the fact that tumors show neovascularity, with increased blood flow and increased vascular leakiness, and relies on the differential enhancement between neoplastic tissue and normal breast parenchyma [9][10][11][12][13]. It has been postulated that benign enhancement may obscure the detection of small cancers by masking this difference. In addition, although MRI is very sensitive for the detection of malignancy, specificity is somewhat Wo m e n's I m ag i ng • O r ig i n a l R e s e a rc h CMEThis article is available for CME credit. See www.arrs.org for more information. 2011; 196:218-224 0361-803X/11/1961-218 © American Roentgen Ray Society B ackground parenchymal enhancement on breast MRI refers to the normal enhancement of the patient's fibroglandular tissue seen on the first contrast-enhanced image. Background enhancement is due to the increase in T1 relaxation of tissue that occurs after gadolinium administration, and the degree of enhancement is directly related to vascular supply and permeability. Background parenchymal enhancement is thought to be related to endogenous hormone status and fluctuates with the menstrual cycle, being highest during weeks 1 and 4 and lowest during week 2 [1,2]. It increases in postmenopausal women receiving hormone replacement therapy (HRT) [3]. Changes in background parenchymal enhancement likely correlate to hormone-dependent histopathologic changes that occur Keywords: background parenchymal enhancement, BI-RADS category 3, MRI breast biopsy rate, screening breast MRI DOI:10.2214/AJR.10.4550 AJRReceived March 3, 2010; accepted after revision June 6, 2010. W O M E N ' S I M A G I N GOBJECTIVE. Background parenchymal enhancement on breast MRI refers to normal enhancement of the patient's fibroglandular tissue. The aim of this study was to determine the effect of background parenchymal enhancement on short-interval follow-up, biopsy, and cancer detection rate on baseline screening MRI in a high-risk group.MATERIALS AND METHODS. Two hundred fifty baseline high-risk screening MRI examinations were reviewed. For each, the background parenchymal enhancement pattern was recorded (minimal, ≤ 25%; mild, 26-50%; moderate, 51-75%; and marked, > 75%), as were BI-RADS category, biopsy rate, and final pathology result. Results were compared for each enhancement category.RESULTS. Of the 250 MRI examinations, 24.8% showed minimal enhancement; 34%, mild; 24%, moderate; and 17.2%, marked enhancement. Women with minimal enhancement had a significantly higher number of BI-RADS categories 1 and 2 examinations (64.5%) than women with mild (38.8%), moderate (40%), or marked (25.6%) enhancement. The BI-RADS category 3 rate was 43....

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Section: Background Parenchymal Enhancement On Breast Mrisupporting

confidence: 69%

Section: Discussioncontrasting

confidence: 55%

See 1 more Smart Citation

Background Parenchymal Enhancement on Baseline Screening Breast MRI: Impact on Biopsy Rate and Short-Interval Follow-Up

Hambly

Liberman

Dershaw

et al. 2011

American Journal of Roentgenology

133

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“…Since the breast is a radiosensitive organ and surveillance for women at high risk should begin at an early age, and possibly with greater frequency, radiation exposure associated with mammography is also of concern, especially for women with BRCA1/2 mutations, Li Fraumeni syndrome or ataxia-telangiectasia, for whom there is heightened vulnerability to radiation damage [64,74]. Further, mammography is generally less effective for women with a genetic predisposition to breast cancer due to increased mammographic density [65], although mammography sometimes detects early breast cancers missed on MRI [75]. Moreover, BRCA1-associated breast cancers may appear on MRI as benign, with relatively smooth margins, and/or with enhancement kinetics typical of fibroadenomas [64].…”

Section: Detection Of Pc For Surveillance Of Women At High Breast Canmentioning

confidence: 99%

Robust identification of the cancer biomarker phosphocholine through partitioned envelopes in noisy magnetic resonance spectroscopic data by the non-parametric fast Padé transform

Belkić

2017

J Math Chem

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The recently introduced concept of envelope partitioning for shape estimation within the fast Padé transform (FPT) is presently further explored and solidified. Earlier, noise-free time signals were used and the results were reported for a single model order K . Currently, partitioned envelopes are computed for several values of model orders K by employing noise-corrupted time signals of increasing standard deviations, σ = 0.0289, 0.289, 2.89 in units of root-mean-square of the noise-free time signal. Moreover, spectra averaging is exploited to stabilize shape estimation in face of sensitivity to changes in model order. The main goal of this study is to establish the robustness of the non-parametric FPT for reconstructions of partitioned average envelopes computed with noisy time signals. Both the previous and present illustrations concern synthesized time signals typically encountered in single-voxel magnetic resonance spectroscopy (MRS), akin to in vitro encoding from malignant breast tissue. This particular problem area is chosen for a twofold reason: clinical urgency in cancer medicine, and a huge challenge to reliably identify a key cancer biomarker (phosphocholine), completely hidden underneath a dominant peak (phosphoethanolamine), with a separation of mere 0.001 parts per million of chemical shift. signals, the road would be paved for applications of this special shape estimation to the associated data from in vivo encodings. Partitioned envelopes are important since they offer possibilities to peer into the tightly overlapped resonances by splitting their components apart already at the level of sole total shape spectra. Although constrained by non-parametric estimations, they can still qualitatively decompose the regions of higher spectral density. This would enable subsequent focusing on the most critical spectral regions of interest when solving the local quantification problem by parametric estimations. Such a stepwise strategy is expected to be especially beneficial for multi-voxel magnetic resonance spectroscopic imaging (MRSI), where thousands of noisy spectra need to be processed. The FPT-based partitioned envelopes, followed by accurate local spectral analysis in narrow frequency intervals are poised to help MRSI become an efficient diagnostic modality for everyday clinical practice.

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“…In prospective nonrandomized studies across multiple centres throughout the world, contrast-enhanced mri achieves a high sensitivity of 70%-100% in the initial screening (prevalence) setting, compared with 40% or less for mammography in patients at high risk for developing breast cancer [4][5][6] . The specificity of mri in that setting has been hampered by its difficulty in distinguishing the often overlapping features of benign and malignant lesions, causing higher false-positive rates 7 .…”

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confidence: 99%

Utilization of Magnetic Resonance Imaging in Breast Cancer Screening

et al. 2015

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Early detection of malignancy through breast cancer screening has contributed significantly to the decline in cancer-related mortality 1 . The U.S. Preventive Services Task Force recently reaffirmed its 2009 stance to begin mammography-the primary screening modality-starting from age 50 and continuing until age 74 2 . However, that recommendation applies primarily to women at "average risk" for developing breast cancer during their lifetime. For women at "high risk," the American Cancer Society has recommended magnetic resonance imaging (mri) of the breast as an adjunct to annual screening mammography 3 . How, then, is risk defined, and should these guidelines be strictly followed by clinicians?Here, we focus first on describing the quality of mri as a screening tool. Then, we define risk categories and conclude with a discussion of the need for a more nuanced approach to the incorporation of mri into breast cancer screening.In prospective nonrandomized studies across multiple centres throughout the world, contrast-enhanced mri achieves a high sensitivity of 70%-100% in the initial screening (prevalence) setting, compared with 40% or less for mammography in patients at high risk for developing breast cancer [4][5][6] . The specificity of mri in that setting has been hampered by its difficulty in distinguishing the often overlapping features of benign and malignant lesions, causing higher false-positive rates 7 . It is important to note, however, that these oft-cited statistics actually improve significantly in the setting of subsequent (incidence) screening rounds. As noted by Warner et al. 6 , the rate of benign biopsy is reduced by nearly one half from the initial screening round to the second screening round (11% vs. 6.6%). In a study of mri screening in BRCA mutation carriers and women with high familial risk, Riedl et al. 8 highlighted the improvement in mri specificity from the first screening round to subsequent screening rounds. In addition, mri recall rates in their study declined dramatically from 26% on initial screening to 13% on second screening and 10% on third screening, emphasizing an improvement with successive rounds of screening. That finding was reinforced by Chiarelli and colleagues 9 in their report of the Ontario Breast Screening Program evaluating mri and mammography in high-risk women. Those authors observed lower recall rates with subsequent rounds of screening (when images from a baseline mri are available for comparison) and with increased experience of mri use at testing centres. As noted by Chiarelli et al., mri screening might be criticized for achieving lower positive predictive values, but two thirds of the cancers would be otherwise missed. Therefore, acceptance of a lower positive predictive value of mri screening in return for the gain of a higher detection rate must be considered. In addition, mri can offer an important contribution to the detection of ductal carcinoma in situ (dcis). Kuhl et al. 10 note that more than half of dcis lesions detected only by mri are histologic...

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Efficacy of Magnetic Resonance Imaging and Mammography for Breast Cancer Screening in Women With a Familial or Genetic Predisposition

Cited by 55 publications

References 0 publications

Background Parenchymal Enhancement on Baseline Screening Breast MRI: Impact on Biopsy Rate and Short-Interval Follow-Up

Background Parenchymal Enhancement on Baseline Screening Breast MRI: Impact on Biopsy Rate and Short-Interval Follow-Up

Robust identification of the cancer biomarker phosphocholine through partitioned envelopes in noisy magnetic resonance spectroscopic data by the non-parametric fast Padé transform

Utilization of Magnetic Resonance Imaging in Breast Cancer Screening

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