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MRI breast screening in high-risk women: cancer detection and survival analysis

MRI breast screening in high-risk women: cancer detection and survival analysis
MRI breast screening in high-risk women: cancer detection and survival analysis
Women with a genetic predisposition to breast cancer tend to develop the disease at a younger age with denser breasts making mammography screening less effective. The introduction of magnetic resonance imaging (MRI) for familial breast cancer screening programs in recent years was intended to improve outcomes in these women. We aimed to assess whether introduction of MRI surveillance improves 5- and 10-year survival of high-risk women and determine the accuracy of MRI breast cancer detection compared with mammography-only or no enhanced surveillance and compare size and pathology of cancers detected in women screened with MRI + mammography and mammography only. We used data from two prospective studies where asymptomatic women with a very high breast cancer risk were screened by either mammography alone or with MRI also compared with BRCA1/2 carriers with no intensive surveillance. 63 cancers were detected in women receiving MRI + mammography and 76 in women receiving mammography only. Sensitivity of MRI + mammography was 93 % with 63 % specificity. Fewer cancers detected on MRI were lymph node positive compared to mammography/no additional screening. There were no differences in 10-year survival between the MRI + mammography and mammography-only groups, but survival was significantly higher in the MRI-screened group (95.3 %) compared to no intensive screening (73.7 %; p = 0.002). There were no deaths among the 21 BRCA2 carriers receiving MRI. There appears to be benefit from screening with MRI, particularly in BRCA2 carriers. Extended follow-up of larger numbers of high-risk women is required to assess long-term survival.
MRI, breast cancer, BRCA1, BRCA2, survival
0167-6806
663-672
Gareth, Evans D.
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Nisha, Kesavan
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Yit, Lim
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Soujanye, Gadde
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Emma, Hurley
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Massat, Nathalie J.
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Maxwell, Anthony J.
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Sarah, Ingham
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Rosalind, Eeles
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Leach, Martin O.
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Anthony, Howell
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Stephen, Duffy
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Lucassen, Anneke
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Eccles, Diana
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Crawford, Gillian
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Gareth, Evans D.
59f75929-cda1-40eb-aaba-2d2057b56004
Nisha, Kesavan
47ba6bd8-cd31-4abe-ab42-b3073fe67e23
Yit, Lim
1c6fecd1-4f39-4086-8318-882bdebbf0a4
Soujanye, Gadde
56ac2970-d32d-40a3-ab6b-05d9eb7388d2
Emma, Hurley
f884aa30-5ea9-45f0-b869-a5ad8d704aec
Massat, Nathalie J.
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Maxwell, Anthony J.
f217207f-4288-4729-b96a-15e02f701801
Sarah, Ingham
03b3a3da-522a-4924-ad3a-f4fc2f636c5c
Rosalind, Eeles
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Leach, Martin O.
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Anthony, Howell
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Stephen, Duffy
cd441f8d-6891-487c-975c-1f8adde9d791
Lucassen, Anneke
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Eccles, Diana
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Crawford, Gillian
c49ec103-2936-4897-8f25-96abe25b3a9f

Gareth, Evans D., Nisha, Kesavan, Yit, Lim, Soujanye, Gadde, Emma, Hurley, Massat, Nathalie J., Maxwell, Anthony J., Sarah, Ingham, Rosalind, Eeles, Leach, Martin O., Anthony, Howell, Stephen, Duffy, Lucassen, Anneke, Eccles, Diana and Crawford, Gillian (2014) MRI breast screening in high-risk women: cancer detection and survival analysis. Breast Cancer Research and Treatment, 145 (3), 663-672. (doi:10.1007/s10549-014-2931-9). (PMID:24687378)

Record type: Article

Abstract

Women with a genetic predisposition to breast cancer tend to develop the disease at a younger age with denser breasts making mammography screening less effective. The introduction of magnetic resonance imaging (MRI) for familial breast cancer screening programs in recent years was intended to improve outcomes in these women. We aimed to assess whether introduction of MRI surveillance improves 5- and 10-year survival of high-risk women and determine the accuracy of MRI breast cancer detection compared with mammography-only or no enhanced surveillance and compare size and pathology of cancers detected in women screened with MRI + mammography and mammography only. We used data from two prospective studies where asymptomatic women with a very high breast cancer risk were screened by either mammography alone or with MRI also compared with BRCA1/2 carriers with no intensive surveillance. 63 cancers were detected in women receiving MRI + mammography and 76 in women receiving mammography only. Sensitivity of MRI + mammography was 93 % with 63 % specificity. Fewer cancers detected on MRI were lymph node positive compared to mammography/no additional screening. There were no differences in 10-year survival between the MRI + mammography and mammography-only groups, but survival was significantly higher in the MRI-screened group (95.3 %) compared to no intensive screening (73.7 %; p = 0.002). There were no deaths among the 21 BRCA2 carriers receiving MRI. There appears to be benefit from screening with MRI, particularly in BRCA2 carriers. Extended follow-up of larger numbers of high-risk women is required to assess long-term survival.

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More information

Accepted/In Press date: 18 March 2014
e-pub ahead of print date: 1 April 2014
Published date: 2014
Keywords: MRI, breast cancer, BRCA1, BRCA2, survival
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 373472
URI: http://eprints.soton.ac.uk/id/eprint/373472
ISSN: 0167-6806
PURE UUID: 827424fd-1649-4fd6-b322-585d5d7cee20
ORCID for Anneke Lucassen: ORCID iD orcid.org/0000-0003-3324-4338
ORCID for Diana Eccles: ORCID iD orcid.org/0000-0002-9935-3169

Catalogue record

Date deposited: 20 Jan 2015 15:13
Last modified: 19 Feb 2021 02:33

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Contributors

Author: Evans D. Gareth
Author: Kesavan Nisha
Author: Lim Yit
Author: Gadde Soujanye
Author: Hurley Emma
Author: Nathalie J. Massat
Author: Anthony J. Maxwell
Author: Ingham Sarah
Author: Eeles Rosalind
Author: Martin O. Leach
Author: Howell Anthony
Author: Duffy Stephen
Author: Anneke Lucassen ORCID iD
Author: Diana Eccles ORCID iD

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