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Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features

Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features
Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features
Our review of the images from prior MR imaging examinations shows that the cancers grow in size and that enhancement curves change from type 1 to type 2 or 3 and demonstrate greater signal enhancement over time.

Purpose
To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer.

Materials and Methods
Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27–55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes.

Results
With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y.

Conclusion
When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.
0033-8419
Gilbert, F. J.
e4ce6e25-e57a-44b7-84de-20ddf05d90aa
Warren, R. M.
f3cfd6b8-abd2-4e50-8fd3-828895cbdc17
Kwan-Lim, G.
dbddc486-8cd8-4694-826d-e9de9e574988
Thompson, Deborah J.
3f8c6676-2926-4dab-bc1c-c690135296c4
Eeles, Ros A.
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Evans, D. Gareth
0b56e8cc-d65b-4a67-80ba-cf988f51a94f
Leach, M. O.
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Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group
Gilbert, F. J.
e4ce6e25-e57a-44b7-84de-20ddf05d90aa
Warren, R. M.
f3cfd6b8-abd2-4e50-8fd3-828895cbdc17
Kwan-Lim, G.
dbddc486-8cd8-4694-826d-e9de9e574988
Thompson, Deborah J.
3f8c6676-2926-4dab-bc1c-c690135296c4
Eeles, Ros A.
b4d711ae-9a55-4557-ad7a-1071488185bb
Evans, D. Gareth
0b56e8cc-d65b-4a67-80ba-cf988f51a94f
Leach, M. O.
4e96d11e-583e-4eb5-a045-f485b71488a1
Lucassen, Anneke
2eb85efc-c6e8-4c3f-b963-0290f6c038a5

Gilbert, F. J., Warren, R. M., Kwan-Lim, G., Thompson, Deborah J., Eeles, Ros A., Evans, D. Gareth and Leach, M. O. , United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group (2009) Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features. Radiology. (doi:10.1148/radiol.2522081032).

Record type: Article

Abstract

Our review of the images from prior MR imaging examinations shows that the cancers grow in size and that enhancement curves change from type 1 to type 2 or 3 and demonstrate greater signal enhancement over time.

Purpose
To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer.

Materials and Methods
Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27–55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes.

Results
With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y.

Conclusion
When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.

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More information

Published date: 1 August 2009

Identifiers

Local EPrints ID: 472040
URI: http://eprints.soton.ac.uk/id/eprint/472040
ISSN: 0033-8419
PURE UUID: 5fd94026-c6b2-47ce-84d7-eb61f7ff0632
ORCID for Anneke Lucassen: ORCID iD orcid.org/0000-0003-3324-4338

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Date deposited: 24 Nov 2022 17:36
Last modified: 17 Mar 2024 02:54

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Contributors

Author: F. J. Gilbert
Author: R. M. Warren
Author: G. Kwan-Lim
Author: Deborah J. Thompson
Author: Ros A. Eeles
Author: D. Gareth Evans
Author: M. O. Leach
Author: Anneke Lucassen ORCID iD
Corporate Author: United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group

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