Screening MRI Does Not Increase Cancer Detection or Result in an Earlier Stage at Diagnosis for Patients with High-Risk Breast Lesions: A Propensity Score Analysis

Laws, Alison; Katlin, Fisher; Hans, Marybeth; Graichen, Mary; Kantor, Olga; Minami, Christina A.; Bychkovsky, Brittany; Pace, Lydia E.; Scheib, Rochelle; Garber, Judy E.; King, Tari A.

doi:10.1245/s10434-022-12568-z

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…Novel screening techniques such as MRI, lacking harmful ionizing radiation, do not show an overall benefit over mammography [ 36 ]. A randomized trial in the Netherlands revealed that MRI screening detected cancers at an earlier stage than mammography in women with familial cancer [ 37 ]. The lower number of late-stage cancers identified in incident rounds might reduce the use of adjuvant chemotherapy and decrease breast-cancer-related mortality [ 38 ].…”

Section: Screeningmentioning

confidence: 99%

Breast Cancer: Impact of New Treatments?

Storme

2023

Cancers

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Background: Breast cancer treatment has seen tremendous progress since the early 1980s, with the first findings of new chemotherapy and hormone therapies. Screening started in the same period. Methods: A review of population data (SEER and the literature) shows an increase in recurrence-free survival until 2000 and it stagnates afterwards. Results: Over the period 1980-2000, the 15% survival gain was presented by pharma as a contribution of new molecules. The contribution of screening during that same period was not implemented by them, although screening has been accepted as a routine procedure in the States since the 1980s and everywhere else since 2000. Conclusions: Interpretation of breast cancer outcome has largely focused on drugs, whereas other factors, such as screening, prevention, biologics, and genetics, were largely neglected. More attention should now be paid to examining the strategy based on realistic global data.

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Section: Screeningmentioning

confidence: 99%

Breast Cancer: Impact of New Treatments?

Storme

2023

Cancers

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“…In addition, NCCN mentions that the sensitivity of MRI in detecting cancerous lesions in women with this history is questionable. This suggestion is based on a prospective study where the combination of mammography and MRI did not significantly improve the detection rate but increased the biopsy rate from 12.6% in screening with mammography alone, to 30.5% (HR: 2.67; p < 0.001) [ 47 ]. On the other hand, as there is a lack of sufficient data, NCCN suggests screening with a combination of both techniques, pending more evidence-based guidelines.…”

Section: Screening Recommendations For Women At High-riskmentioning

confidence: 99%

Screening for Breast Cancer: A Comparative Review of Guidelines

Katsika,

Boureka,

Kalogiannidis

et al. 2024

Life

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Breast cancer is the most common malignancy diagnosed in the female population worldwide and the leading cause of death among perimenopausal women. Screening is essential, since earlier detection in combination with improvements in breast cancer treatment can reduce the associated mortality. The aim of this study was to review and compare the recommendations from published guidelines on breast cancer screening. A total of 14 guidelines on breast cancer screening issued between 2014 and 2022 were identified. A descriptive review of relevant guidelines by the World Health Organization (WHO), the U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN), the American College of Obstetricians and Gynecologists (ACOG), the American Society of Breast Surgeons (ASBrS), the American College of Radiology (ACR), the Task Force on Preventive Health Care (CTFPHC), the European Commission Initiative on Breast Cancer (ECIBC), the European Society for Medical Oncology (ESMO), the Royal Australian College of General Practitioners (RACGP) and the Japanese Journal of Clinical Oncology (JJCO) for women both at average and high-risk was carried out. There is a consensus among all the reviewed guidelines that mammography is the gold standard screening modality for average-risk women. For this risk group, most of the guidelines suggest annual or biennial mammographic screening at 40–74 years, while screening should particularly focus at 50–69 years. Most of the guidelines suggest that the age limit to stop screening should be determined based on the women’s health status and life expectancy. For women at high-risk, most guidelines recommend the use of annual mammography or magnetic resonance imaging, while the starting age should be earlier than the average-risk group, depending on the risk factor. There is discrepancy among the recommendations regarding the age at onset of screening in the various high-risk categories. The development of consistent international practice protocols for the most appropriate breast cancer screening programs seems of major importance to reduce mortality rates and safely guide everyday clinical practice.

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“…It is unclear how breast cancer risk calculators were utilized by clinicians in this high-risk clinic to determine the addition of MRI to screening, 5 and whether patients who were at the higher end of the continuum (i.e. 18% lifetime risk) were more likely to undergo MRI.…”

Section: Personalized Screeningmentioning

confidence: 99%

“…This was recognized by the authors and explains why MRI was utilized more often in patients who were younger (median age 51 vs. 55 years, p \ 0.001), and those with extremely dense breasts (25% vs. 10%, p \ 0.001), stronger family history of breast cancer (24% vs. 16%, p = 0.02), and history of LCIS versus ADH/ALH (28% vs. 21%, p = 0.05). 5 At the end of the day, the question of which population really benefits is something that we still do not know for sure, and as with all good manuscripts, there are now more questions to answer. DISCLOSURES Juan C. Paramo and Roshni Rao declare no conflicts of interest.…”

Section: Shared Decision Makingmentioning

confidence: 99%

“…In the current issue of Annals of Surgical Oncology, the authors 5 present a most pertinent question-what is the additive clinical value of surveillance MRI in patients with a history of atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and lobular carcinoma in situ (LCIS)? The authors report on 699 patients followed in a high-risk clinic due to a history of the aforementioned high-risk lesions.…”

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confidence: 99%

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