MRI in high risk women: benefits and problems

Cortesi, Laura; Pecchi, Annarita; Matteis, Elisabetta De; Filieri, Elisabetta; Battista, Rachele; Canossi, Barbara; Torricelli, Pietro; Federico, Massimo

doi:10.1016/s0720-048x(12)70008-6

Cited by 2 publications

(2 citation statements)

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“…Interestingly, tumor size has been increasing over the last two decade, probably due to the improvements in radiological techniques. At the beginning of nineties, most of de novo metastatic patients were only clinically examined, whereas recently other techniques, including breast MRI, are routinely used to better define the real extension of the disease . An improvement in radiological investigations could also explain the significant reduction of single metastatic sites at the diagnosis observed in the last period.…”

Section: Discussionmentioning

confidence: 99%

“…At the beginning of nineties, most of de novo metastatic patients were only clinically examined, whereas recently other techniques, including breast MRI, are routinely used to better define the real extension of the disease. [14][15][16] An improvement in radiological investigations could also explain the significant reduction of single metastatic sites at the diagnosis observed in the last period. In fact, in the period 2006-2009, about 45% of metastases were more likely to be multiple, probably due to a better study of the disease since the diagnosis with CT or PET scan.…”

Section: Discussionmentioning

confidence: 99%

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Twenty-years experience withde novometastatic breast cancer

et al. 2015

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Although new treatments have been widely studied to improve the survival of patients with metastatic breast cancer (BC), prognosis continues to be poor with an average survival time no longer than 3 years. We carried on a population-based study with the purpose of evaluating the outcome of metastatic breast cancer in the province of Modena from 1990 to 2009. We examined the Modena Cancer Registry and evaluated the 5-year overall survival (OS) of women diagnosed with a de novo metastatic breast cancer between 1990 and 2009, defining 5 periods of 4 years each. After a median followup time of 29 months, the 5-year OS was 11% for years 1990-1993, 15% for years 1994-1997, 12% for years 1998-2001, 20% for years 2002-2005 and 29% for years 2006-2009 (p 5 0.012). Overall, although no OS differences were noted in the first decade analyzed, a real advantage has been shown in the last two cohorts. In a multivariate analysis, the 5-year OS was significantly increased only for hormone receptor positive and HER21 tumors, whereas chemotherapy treatments were not significant independent predictors of survival in "de novo" metastatic BC (p 5 0.08). Our analysis confirms that the prognosis of de novo metastatic breast cancer has improved overtime, particularly in the last decade. Trastuzumab, LH-RH analogues and aromatase inhibitors have determined a significant clinical benefit and costeffectiveness in metastatic breast cancer treatment.Breast cancer (BC) continues to be the most common form of cancer that affects women, but currently is no longer the leading cause of cancer deaths. However, the prognosis of patients with metastatic disease continues to be poor, with an average survival time no longer than 3 years.1,2 Although clinical trials suggest that early detection strategies and advances in adjuvant therapy are improving outcomes, it is unclear if this may affect patterns of relapse and 20-30% of patients with early BC will eventually develop relapse with distant metastatic disease. Therefore, distant recurrence remains common and incurable and, currently, the principal goal of treatment for women with metastatic disease is to improve quality of life and to prolong survival. 3,4 Although new treatments have been widely investigated in the metastatic setting, it is not clear whether the overall outcome has improved. Particularly, Seruga et al.5 observed no significant change in outcome or in absolute benefit of experimental therapies in Phase III randomized clinical trials evaluating treatment for metastatic BC. Moreover, the costs of experimental medical therapies approved for metastatic disease increase [mt]100-fold each month, without any gain in the absolute benefit. Therefore, Seruga et al.5 demonstrated that new and expensive treatments of metastatic BC lead to unchanging levels of benefit and rapidly increasing costs, concluding that new therapies are becoming much less costeffective. Moreover, Galy et al.6 performed a retrospective study to examine temporal trends in the use of chemotherapeutic agents for the treat...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Twenty-years experience withde novometastatic breast cancer

et al. 2015

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Imaging surveillance programs for women at high breast cancer risk in Europe: Are women from ethnic minority groups adequately included? (Review)

Belkić

Cohen

Wilczek

et al. 2015

International Journal of Oncology

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Abstract. Women from ethnic minority groups, including immigrants and refugees are reported to have low breast cancer (BC) screening rates. Active, culturally-sensitive outreach is vital for increasing participation of these women in BC screening programs. Women at high BC risk and who belong to an ethnic minority group are of special concern. Such women could benefit from ongoing trials aimed at optimizing screening strategies for early BC detection among those at increased BC risk. Considering the marked disparities in BC survival in Europe and its enormous and dynamic ethnic diversity, these issues are extremely timely for Europe. We systematically reviewed the literature concerning European surveillance studies that had imaging in the protocol and that targeted women at high BC risk. The aim of the present review was thereby to assess the likelihood that women at high BC risk from minority ethnic groups were adequately included in these surveillance programs. Twenty-seven research groups in Europe reported on their imaging surveillance programs for women at increased BC risk. The benefit of strategies such as inclusion of magnetic resonance imaging and/or more intensive screening was clearly documented for the participating women at increased BC risk. However, none of the reports indicated that sufficient outreach was performed to ensure that women at increased BC risk from minority ethnic groups were adequately included in these surveillance programs. On the basis of this systematic review, we conclude that the specific screening needs of ethnic minority women at increased BC risk have not yet been met in Europe. Active, culturally-sensitive outreach is needed to identify minority women at increased BC risk and to facilitate their inclusion in on-going surveillance programs. It is anticipated that these efforts would be most effective if coordinated with the development of European-wide, population-based approaches to BC screening. Contents

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MRI in high risk women: benefits and problems

Cited by 2 publications

References 13 publications

Twenty-years experience withde novometastatic breast cancer

Twenty-years experience withde novometastatic breast cancer

Imaging surveillance programs for women at high breast cancer risk in Europe: Are women from ethnic minority groups adequately included? (Review)

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