European Radiology

, 17:873

Breast MR imaging in women at high-risk of breast cancer. Is something changing in early breast cancer detection?

Breast

DOI: 10.1007/s00330-006-0389-9

Cite this article as:
Sardanelli, F. & Podo, F. Eur Radiol (2007) 17: 873. doi:10.1007/s00330-006-0389-9

Abstract

In the last few years, several papers have addressed the introduction of contrast-enhanced MR imaging for screening women at high risk for breast cancer. Taking in consideration five prospective studies, on 3,571 screened women with hereditary predisposition to the disease and 9,652 rounds, we found that 168 patients were diagnosed with breast cancer (155 screen-detected, eight interval, and five cancers excluded from analysis) with a detection rate per year of 1.7%. These cancers were small (49% equal to or less than 10 mm in diameter) but aggressive, 82% being invasive and 49% with histologic grade 3; however, only 19% of these invasive cancers were associated with nodal involvement. The pooled sensitivity was 16% for clinical breast examination, 40% for mammography, 43% for ultrasound, and 81% for MR. The positive predictive value (calculated on the basis of the number of invasive diagnostic procedures due to false positives) was 33%, 47%, 18%, and 53%, respectively. Aim of the present article is to present the historical development of MR imaging of breast tumors that made this application theoretically and technically possible, to explain what strategic problems we face in the presence of a hereditary predisposition to the disease, to review the main results of the published studies, and to outline open problems and future perspectives.

Keywords

Breast neoplasmsMRCancer screeningGenes and genetics

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Medical and Surgical Sciences, Unit of Radiology, IRCCS Policlinico San DonatoUniversity of Milan School of MedicineSan Donato MilaneseItaly
  2. 2.Department of Cell Biology and NeuroscienceIstituto Superiore di SanitàRomeItaly