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Factors Affecting Sensitivity and Specificity of Screening Mammography and MRI in Women with an Inherited Risk for Breast Cancer

  • Epidemiology
  • Published:
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Abstract

Background

The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specificity was 95 and 90%, respectively. In the current subsequent study we investigated whether these results are influenced by age, a BRCA1/2 mutation, menopausal status and breast density.

Patients and methods

From November 1999 to October 2003, 1909 eligible women were screened and 50 breast cancers were detected. For the current analysis, data of 4134 screening rounds and 45 detected breast cancers were used. For both imaging modalities, screening parameters, receiver operating characteristic (ROC) curves and uni- and multivariate odds ratios (ORs) were calculated. All analyses were separately performed for age at entry (< 40, 40–49, ≥50), mutation status, menopausal status and breast density.

Results

Sensitivity of MRI was decreased in women with high breast density (adjusted OR 0.08). False-positive rates of both mammography (ORadj 1.67) and MRI (ORadj 1.21) were increased by high breast density, that of MRI by pre-menopausal status (ORadj 1.70), young age (ORadj 1.58 for women 40–49 years versus women ≥50 years) and decreased in BRCA1/2 mutation carriers (ORadj 0.74).

In all investigated subgroups the discriminating capacity (measured by the area under the ROC-curve) was higher for MRI than for mammography, with the largest differences for BRCA1/2 mutation carriers (0.237), for women between 40 and 49 years (0.227) and for women with a low breast density (0.237).

Conclusions

This report supports the earlier recommendation that MRI should be a standard screening method for breast cancer in BRCA1/2 mutation carriers.

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Acknowledgement

Supported by a grant (OG 98-03) from the Dutch Health Insurance Council.

Author information

Authors and Affiliations

  1. Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075 EA, Rotterdam, the Netherlands

    Mieke Kriege, Cecile T. M. Brekelmans, Caroline Seynaeve & Jan G. M. Klijn

  2. Family Cancer Clinic, Department of Radiology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands

    Inge Marie Obdeijn

  3. Department of Radiology, University Medical Center, Nijmegen, the Netherlands

    Carla Boetes

  4. Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands

    Harmine M. Zonderland

  5. Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands

    Sara H. Muller & A. Peter E. Besnard

  6. Department of Radiology, University Medical Center, University of Groningen, Groningen, the Netherlands

    Theo Kok

  7. Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands

    Radu A. Manoliu

  8. Family Cancer Clinic, Department of Surgery, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, the Netherlands

    Madeleine M. A. Tilanus-Linthorst & Carina C. M. Bartels

  9. Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands

    Reini Kaas & Emiel J. T. Rutgers

  10. Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands

    Siebren Meijer

  11. Department of Clinical Genetics, University Medical Center, University of Groningen, Groningen, the Netherlands

    Jan C. Oosterwijk

  12. Family Cancer Clinic, University Medical Center, Nijmegen, the Netherlands

    Nicoline Hoogerbrugge

  13. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

    Rob A. E. M. Tollenaar

  14. Department of Public Health, Erasmus MC, Rotterdam, the Netherlands

    Harry J. de Koning

Authors
  1. Mieke Kriege
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  2. Cecile T. M. Brekelmans
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  9. A. Peter E. Besnard
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  10. Madeleine M. A. Tilanus-Linthorst
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  12. Carina C. M. Bartels
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  15. Jan C. Oosterwijk
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  16. Nicoline Hoogerbrugge
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  17. Rob A. E. M. Tollenaar
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  18. Emiel J. T. Rutgers
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  19. Harry J. de Koning
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  20. Jan G. M. Klijn
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Correspondence to Jan G. M. Klijn.

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Kriege, M., Brekelmans, C.T.M., Obdeijn, I.M. et al. Factors Affecting Sensitivity and Specificity of Screening Mammography and MRI in Women with an Inherited Risk for Breast Cancer. Breast Cancer Res Treat 100, 109–119 (2006). https://doi.org/10.1007/s10549-006-9230-z

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  • DOI: https://doi.org/10.1007/s10549-006-9230-z

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