Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast Cancer

Kuhl, Christiane K.; Schrading, Simone; Leutner, C.; Morakkabati-Spitz, N; Wardelmann, Eva; Fimmers, Rolf; Kuhn, Walther; Schild, Hans H.

doi:10.1200/jco.2004.00.4960

Cited by 1,018 publications

(706 citation statements)

References 36 publications

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“…Conform to our previous results and the results from other prospective studies [15][16][17][18][19], the sensitivity of contrastenhanced MR imaging for breast cancer screening in women with a familial or genetic predisposition is significantly higher compared to the sensitivity of mammography. However, MRI demonstrated not all malignancies.…”

Section: Discussionsupporting

confidence: 86%

“…In our study, mammography and MRI were complimentary for the detection of DCIS, with a higher sensitivity for mammography. Pooling together the 40 cases of DCIS detected in the mid-term analysis of the MRISC study and of the Canadian, English, German, and Italian screening studies [16][17][18][19], MRI has a sensitivity of 60% (23/38) (two patients with DCIS did not underwent MR). The sensitivity of mammography for DCIS is 60% (24/40) while 10 of the 40 (25%) cases were detected only by mammography.…”

Section: Discussionmentioning

confidence: 99%

“…The MRI sensitivity for DCIS in the present study is conform to the MARIBS study [17], where two of the six DCIS were diagnosed with MR (sensitivity 33%), but lower than reported in the other screening studies. Warner et al [16] detected four out of six DCIS with MRI (sensitivity 67%), while Kuhl et al [18] diagnosed eight out of nine intraductal cancers with MRI (sensitivity 89%). In the study of Sardanelli et al [19] all four cases of DCIS were diagnosed with MRI (sensitivity 100%).…”

Section: Discussionmentioning

confidence: 99%

“…In five prospective studies [15][16][17][18][19], 3,571 women were screened with contrast-enhanced MR imaging and mammography, and with ultrasound in three of five studies. The pooled sensitivity for mammography was 40%, in comparison to 81% for MRI [20].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

Obdeijn

Loo

Rijnsburger

et al. 2009

Breast Cancer Res Treat

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In order to assess the characteristics of malignant breast lesions those were not detected during screening by MR imaging. In the Dutch MRI screening study (MRISC), a non-randomized prospective multicenter study, women with high familial risk or a genetic predisposition for breast cancer were screened once a year by mammography and MRI and every 6 months with a clinical breast examination (CBE). The false-negative MR examinations were subject of this study and were retrospectively reviewed by two experienced radiologists. From November 1999 until March 2006, 2,157 women were eligible for study analyses. Ninety-seven malignant breast tumors were detected, including 19 DCIS (20%). In 22 patients with a malignant lesion, the MRI was assessed as BI-RADS 1 or 2. One patient was excluded because the examinations were not available for review. Forty-three percent (9/21) of the false-negative MR cases concerned pure ductal carcinoma in situ (DCIS) or DCIS with invasive foci, in eight of them no enhancement was seen at the review. In six patients the features of malignancy were missed or misinterpreted. Small lesion size (n = 3), extensive diffuse contrast enhancement of the breast parenchyma (n = 2), and a technically inadequate examination (n = 1) were other causes of the missed diagnosis. A major part of the false-negative MR diagnoses concerned non-enhancing DCIS, underlining the necessity of screening not only with MRI but also with mammography. Improvement of MRI scanning protocols may increase the detection rate of DCIS. The missed and misinterpreted cases are reflecting the learning curve of a multicenter study.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

Obdeijn

Loo

Rijnsburger

et al. 2009

Breast Cancer Res Treat

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“…Magnetic resonance imaging (MRI) has been implemented in the clinical practice of breast imaging for its ability to detect and visualize tumors far more sensitively and accurately than other conventional imaging modalities, such as mammography and ultrasound 8 , 12 . At our institution, MR imaging studies are nearly imperative for those patients who are candidates for breast conservation therapy for precise evaluation of the extent of the cancer.…”

Section: Introductionmentioning

confidence: 99%

Comparing post‐operative human breast specimen radiograph and MRI in lesion margin and volume assessment

Abé

Shimauchi

Fan

et al. 2012

J Applied Clin Med Phys

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The purpose of this research is to evaluate the potential for identifying malignant breast lesions and their margins on large specimen MRI, in comparison to specimen radiography and clinical dynamic contrast enhanced MRI (DCE‐MRI). Breast specimens were imaged with an MR scanner immediately after surgery, with an IRB‐approved protocol and with the patients' informed consent. Specimen sizes were at least 5 cm in diameter and approximately 1 to 4 cm thick. Coronal and axial gradient echo MR images without fat suppression were acquired over the whole specimens using a 9.4T animal scanner. Findings on specimen MRI were compared with findings on specimen radiograph, and their volumes were compared with measurements obtained from clinical DCE‐MRI. The results showed that invasive ductal carcinoma (IDC) lesions were easily identified using MRI and the margins were clearly distinguishable from nearby tissue. However, ductal carcinoma in situ (DCIS) lesions were not clearly discernible and were diffused with poorly defined margins on MRI. Calcifications associated with DCIS were visualized in all specimens on specimen radiograph. There is a strong correlation between the maximum diameter of lesions as measured by radiograph and MRI (r=0.93), as well as the maximum diameter measured by pathology and radiograph/MRI (r < 0.75). The volumes of IDC measured on specimen MRI were slightly smaller than those measured on DCE‐MRI. Imaging of excised human breast lumpectomy specimens with high magnetic field MRI provides promising results for improvements in lesion identification and margin localization for IDC. However, there are technical challenges in visualization of DCIS lesions. Improvements in specimen imaging are important, as they will provide additional information to standard radiographic analysis.PACS numbers: 87.61.Tg; 87.59.B

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Management of Women With BRCA Mutations

Tung¹

2011

JAMA

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Ms E, a 41-year-old BRCA1 mutation carrier, was diagnosed 4 years ago as having breast cancer and opted for breast-conserving therapy. Prior to receiving chemotherapy, she harvested her eggs through in vitro fertilization and subsequently used preimplantation genetic diagnosis; 3 months ago she delivered a healthy boy. This review examines the prevalence of BRCA mutations in women with breast cancer, as well as current recommendations for surgery and systemic therapy in these women. In particular, the risk of a contralateral breast cancer is reviewed to help guide the choice of prophylactic mastectomies vs breast-conserving therapy. The technology of preimplantation genetic diagnosis and genetic testing in relatives of mutation carriers is discussed.

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Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast Cancer

Cited by 1,018 publications

References 36 publications

Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

Comparing post‐operative human breast specimen radiograph and MRI in lesion margin and volume assessment

Management of Women With BRCA Mutations

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