Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: A prospective multicentre cohort study (MARIBS)
Leach, M.O., Boggis, C.R., Dixon, A.K., Easton, D.F., Eeles, R.A., Evans, D.G., Gilbert, F.J., Griebsch, I., Hoff, R.J., Kessar, P., Lakhani, S.R., Moss, S.M., Nerurkar, A., Padhani, A.R., Pointon, L.J., Thompson, D., Warren, R.M. and MARIBS, study group (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). Lancet, 365, (9473), 1769-1778. (doi:10.1016/S0140-6736(05)66481-1).
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Women genetically predisposed to breast cancer often develop the disease at a young age when dense breast tissue reduces the sensitivity of X-ray mammography. Our aim was, therefore, to compare contrast enhanced magnetic resonance imaging (CE MRI) with mammography for screening.
We did a prospective multicentre cohort study in 649 women aged 35–49 years with a strong family history of breast cancer or a high probability of a BRCA1, BRCA2, or TP53 mutation. We recruited participants from 22 centres in the UK, and offered the women annual screening with CE MRI and mammography for 2–7 years.
We diagnosed 35 cancers in the 649 women screened with both mammography and CE MRI (1881 screens): 19 by CE MRI only, six by mammography only, and eight by both, with two interval cases. Sensitivity was significantly higher for CE MRI (77%, 95% CI 60–90) than for mammography (40%, 24–58; p=0·01), and was 94% (81–99) when both methods were used. Specificity was 93% (92–95) for mammography, 81% (80–83) for CE MRI (p<0·0001), and 77% (75–79) with both methods. The difference between CE MRI and mammography sensitivities was particularly pronounced in BRCA1 carriers (13 cancers; 92% vs 23%, p=0·004).
Our findings indicate that CE MRI is more sensitive than mammography for cancer detection. Specificity for both procedures was acceptable. Despite a high proportion of grade 3 cancers, tumours were small and few women were node positive. Annual screening, combining CE MRI and mammography, would detect most tumours in this risk group.
|Digital Object Identifier (DOI):||doi:10.1016/S0140-6736(05)66481-1|
|Subjects:||H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
|Divisions:||University Structure - Pre August 2011 > School of Medicine > Cancer Sciences
|Date Deposited:||07 Jul 2006|
|Last Modified:||31 Mar 2016 12:11|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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