Screening MRI in Women With a Personal History of Breast Cancer
Authors:
- Constance D. LehmanCLConstance D. Lehman
- Janie M. LeeJLJanie M. Lee
- Wendy B. DeMartiniWDWendy B. DeMartini
- Daniel S. HippeDHDaniel S. Hippe
- Mara H. RendiMRMara H. Rendi
- Grace KalishGKGrace Kalish
- Peggy PorterPPPeggy Porter
- Julie GralowJGJulie Gralow
- Savannah C. PartridgeSPSavannah C. Partridge
- 7 January 2016
- journal article
- research article
- Published by Oxford University Press (OUP) in JNCI: Journal of the National Cancer Institute
- Vol. 108 (3) , djv349
Abstract
Background: Screening MRI is recommended for individuals at high risk for breast cancer, based on genetic risk or family history (GFH); however, there is insufficient evidence to support screening MRI for women with a personal history (PH) of breast cancer. We compared screening MRI performance in women with PH vs GFH of breast cancer. Methods: We analyzed case-series registry data, collected at time of MRI and at 12-month follow-up, from our regional Clinical Oncology Data Integration project. MRI performance was compared in women with PH with those with GFH. Chi-square testing was used to identify associations between age, prior history of MRI, and clinical indication with MRI performance; logistic regression was used to determine the combined contribution of these variables in predicting risk of a false-positive exam. All statistical tests were two-sided. Results: Of 1521 women who underwent screening MRI from July 2004 to November 2011, 915 had PH and 606 had GFH of breast cancer. Overall, MRI sensitivity was 79.4% for all cancers and 88.5% for invasive cancers. False-positive exams were lower in the PH vs GFH groups (12.3% vs 21.6%, P < .001), specificity was higher (94.0% vs 86.0%, P < .001), and sensitivity and cancer detection rate were not statistically different (P > .99). Age (P < .001), prior MRI (P < .001), and clinical indication (P < .001) were individually associated with initial false-positive rate; age and prior MRI remained statistically significant in multivariable modeling (P = .001 and P < .001, respectively). Conclusion: MRI performance is superior in women with PH compared with women with GFH. Screening MRI warrants consideration as an adjunct to mammography in women with a PH of breast cancer.Keywords
This publication has 35 references indexed in Scilit:
- Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA TrialJournal of Clinical Oncology, 2010
- Breast Cancer Screening With Imaging: Recommendations From the Society of Breast Imaging and the ACR on the Use of Mammography, Breast MRI, Breast Ultrasound, and Other Technologies for the Detection of Clinically Occult Breast CancerJournal of the American College of Radiology, 2010
- Breast Cancer Screening and DiagnosisJournal of the National Comprehensive Cancer Network, 2009
- Multicenter Comparative Multimodality Surveillance of Women at Genetic-Familial High Risk for Breast Cancer (HIBCRIT Study): Interim ResultsRadiology, 2007
- American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to MammographyCA: A Cancer Journal for Clinicians, 2007
- Breast MR imaging in women at high-risk of breast cancer. Is something changing in early breast cancer detection?European Radiology, 2006
- Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast CancerJournal of Clinical Oncology, 2005
- Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS)The Lancet, 2005
- Screening women at high risk for breast cancer with mammography and magnetic resonance imagingCancer, 2005
- Efficacy of MRI and Mammography for Breast-Cancer Screening in Women with a Familial or Genetic PredispositionNew England Journal of Medicine, 2004