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Predictors associated with MRI surveillance screening in women with a personal history of unilateral breast cancer but without a genetic predisposition for future contralateral breast cancer

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Abstract

Purpose

For women with a personal history of breast cancer (PHBC), no validated mechanisms exist to calculate future contralateral breast cancer (CBC) risk. The Manchester risk stratification guidelines were developed to evaluate CBC risk in women with a PHBC, primarily for surgical decision making. This tool may be informative for the use of MRI screening, as CBC risk is an assumed consideration for high-risk surveillance.

Methods

Three hundred twenty-two women with a PHBC were treated with unilateral surgery within our multidisciplinary breast clinic. We calculated lifetime CBC risk using the Manchester tool, which incorporates age at diagnosis, family history, genetic mutation status, estrogen receptor positivity, and endocrine therapy use. Univariate and multivariate logistic regression analyses (UVA/MVA) were performed, evaluating whether CBC risk predicted MRI surveillance.

Results

For women with invasive disease undergoing MRI surveillance, 66% had low, 23% above-average, and 11% moderate/high risk for CBC. On MVA, previous mammography-occult breast cancer [odds ratio (OR) 18.95, p < 0.0001], endocrine therapy use (OR 3.89, p = 0.009), dense breast tissue (OR 3.69, p = 0.0007), mastectomy versus lumpectomy (OR 3.12, p = 0.0041), and CBC risk (OR 3.17 for every 10% increase, p = 0.0002) were associated with MRI surveillance. No pathologic factors increasing ipsilateral breast cancer recurrence were significant on MVA.

Conclusions

Although CBC risk predicted MRI surveillance, 89% with invasive disease undergoing MRI had <20% calculated CBC risk. Concerns related to future breast cancer detectability (dense breasts and/or previous mammography-occult disease) predominate decision making. Pathologic factors important for determining ipsilateral recurrence risk, aside from age, were not associated with MRI surveillance.

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References

  1. Schacht DV, Yamaguchi K, Lai J, Kulkarni K, Sennett CA, Abe H (2014) Importance of a personal history of breast cancer as a risk factor for the development of subsequent breast cancer: results from screening breast MRI. AJR Am J Roentgenol 202(2):289–292. doi:10.2214/ajr.13.11553

    Article  PubMed  Google Scholar 

  2. Nichols HB, de Gonzalez AB, Lacey JV Jr, Rosenberg PS, Anderson WF (2011) Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol 29(12):1564–1569. doi:10.1200/jco.2010.32.7395

    Article  PubMed  PubMed Central  Google Scholar 

  3. de la Rochefordiere A, Mouret-Fourme E, Asselain B, Scholl SM, Campana F, Broet P, Fourquet A (1996) Metachronous contralateral breast cancer as first event of relapse. Int J Radiat Oncol Biol Phys 36(3):615–621

    Article  PubMed  Google Scholar 

  4. Kollias J, Evans AJ, Wilson AR, Ellis IO, Elston CW, Blamey RW (2000) Value of contralateral surveillance mammography for primary breast cancer follow-up. World J Surg 24(8):983–987 (discussion 988–989)

    Article  CAS  PubMed  Google Scholar 

  5. Weinstock C, Bigenwald R, Hochman T, Sun P, Narod SA, Warner E (2012) Outcomes of surveillance for contralateral breast cancer in patients less than age 60 at the time of initial diagnosis. Curr Oncol 19(3):e160–164. doi:10.3747/co.19.890

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Hill-Kayser CE, Harris EE, Hwang WT, Solin LJ (2006) Twenty-year incidence and patterns of contralateral breast cancer after breast conservation treatment with radiation. Int J Radiat Oncol Biol Phys 66(5):1313–1319. doi:10.1016/j.ijrobp.2006.07.009

    Article  PubMed  Google Scholar 

  7. Robinson A, Speers C, Olivotto I, Chia S (2007) Method of detection of new contralateral primary breast cancer in younger versus older women. Clin Breast Cancer 7(9):705–709. doi:10.3816/CBC.2007.n.030

    Article  PubMed  Google Scholar 

  8. Jacobson JA, Danforth DN, Cowan KH, d’Angelo T, Steinberg SM, Pierce L, Lippman ME, Lichter AS, Glatstein E, Okunieff P (1995) Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med 332(14):907–911. doi:10.1056/nejm199504063321402

    Article  CAS  PubMed  Google Scholar 

  9. Buchanan CL, Dorn PL, Fey J, Giron G, Naik A, Mendez J, Murphy C, Sclafani LM (2006) Locoregional recurrence after mastectomy: incidence and outcomes. J Am Coll Surg 203(4):469–474. doi:10.1016/j.jamcollsurg.2006.06.015

    Article  PubMed  Google Scholar 

  10. Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, Godwin J, Gray R, Pierce L, Whelan T, Wang Y, Peto R (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378(9804):1707–1716. doi:10.1016/s0140-6736(11)61629-2

    Article  CAS  PubMed  Google Scholar 

  11. van Laar C, van der Sangen MJ, Poortmans PM, Nieuwenhuijzen GA, Roukema JA, Roumen RM, Tjan-Heijnen VC, Voogd AC (2013) Local recurrence following breast-conserving treatment in women aged 40 years or younger: trends in risk and the impact on prognosis in a population-based cohort of 1143 patients. Eur J Cancer 49(15):3093–3101. doi:10.1016/j.ejca.2013.05.030

    Article  PubMed  Google Scholar 

  12. Warner E, Messersmith H, Causer P, Eisen A, Shumak R, Plewes D (2008) Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med 148(9):671–679

    Article  PubMed  Google Scholar 

  13. Sung JS, Stamler S, Brooks J, Kaplan J, Huang T, Dershaw DD, Lee CH, Morris EA, Comstock CE (2016) Breast cancers detected at screening MR imaging and mammography in patients at high risk: method of detection reflects tumor histopathologic results. Radiology 280(3):716–722. doi:10.1148/radiol.2016151419

    Article  PubMed  PubMed Central  Google Scholar 

  14. Madorsky-Feldman D, Sklair-Levy M, Perri T, Laitman Y, Paluch-Shimon S, Schmutzler R, Rhiem K, Lester J, Karlan BY, Singer CF, Van Maerken T, Claes K, Brunet J, Izquierdo A, Teule A, Lee JW, Kim SW, Arun B, Jakubowska A, Lubinski J, Tucker K, Poplawski NK, Varesco L, Bonelli LA, Buys SS, Mitchell G, Tischkowitz M, Gerdes AM, Seynaeve C, Robson M, Kwong A, Tung N, Tessa N, Domchek SM, Godwin AK, Rantala J, Arver B, Friedman E (2016) An international survey of surveillance schemes for unaffected BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat. doi:10.1007/s10549-016-3805-0

    PubMed  PubMed Central  Google Scholar 

  15. Ng AK, Garber JE, Diller LR, Birdwell RL, Feng Y, Neuberg DS, Silver B, Fisher DC, Marcus KJ, Mauch PM (2013) Prospective study of the efficacy of breast magnetic resonance imaging and mammographic screening in survivors of Hodgkin lymphoma. J Clin Oncol 31(18):2282–2288. doi:10.1200/jco.2012.46.5732

    Article  PubMed  Google Scholar 

  16. Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA (2007) American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 57(2):75–89

    Article  PubMed  Google Scholar 

  17. Parmigiani G, Berry D, Aguilar O (1998) Determining carrier probabilities for breast cancer-susceptibility genes BRCA1 and BRCA2. Am J Hum Genet 62(1):145–158

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Parmigiani G, Chen S, Iversen ES Jr, Friebel TM, Finkelstein DM, Anton-Culver H, Ziogas A, Weber BL, Eisen A, Malone KE, Daling JR, Hsu L, Ostrander EA, Peterson LE, Schildkraut JM, Isaacs C, Corio C, Leondaridis L, Tomlinson G, Amos CI, Strong LC, Berry DA, Weitzel JN, Sand S, Dutson D, Kerber R, Peshkin BN, Euhus DM (2007) Validity of models for predicting BRCA1 and BRCA2 mutations. Ann Intern Med 147(7):441–450

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ (1989) Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81(24):1879–1886

    Article  CAS  PubMed  Google Scholar 

  20. Benichou J, Gail MH, Mulvihill JJ (1996) Graphs to estimate an individualized risk of breast cancer. J Clin Oncol 14(1):103–110

    Article  CAS  PubMed  Google Scholar 

  21. Tyrer J, Duffy SW, Cuzick J (2004) A breast cancer prediction model incorporating familial and personal risk factors. Stat Med 23(7):1111–1130. doi:10.1002/sim.1668

    Article  PubMed  Google Scholar 

  22. Amir E, Evans DG, Shenton A, Lalloo F, Moran A, Boggis C, Wilson M, Howell A (2003) Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. J Med Genet 40(11):807–814

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Mazzola E, Chipman J, Cheng SC, Parmigiani G (2014) Recent BRCAPRO upgrades significantly improve calibration. Cancer Epidemiol Biomark Prev 23(8):1689–1695. doi:10.1158/1055-9965.epi-13-1364

    Article  Google Scholar 

  24. Chiarelli AM, Prummel MV, Muradali D, Majpruz V, Horgan M, Carroll JC, Eisen A, Meschino WS, Shumak RS, Warner E, Rabeneck L (2014) Effectiveness of screening with annual magnetic resonance imaging and mammography: results of the initial screen from the ontario high risk breast screening program. J Clin Oncol 32(21):2224–2230. doi:10.1200/jco.2013.52.8331

    Article  PubMed  Google Scholar 

  25. Brennan S, Liberman L, Dershaw DD, Morris E (2010) Breast MRI screening of women with a personal history of breast cancer. AJR Am J Roentgenol 195(2):510–516. doi:10.2214/ajr.09.3573

    Article  PubMed  Google Scholar 

  26. Wernli KJ, DeMartini WB, Ichikawa L, Lehman CD, Onega T, Kerlikowske K, Henderson LM, Geller BM, Hofmann M, Yankaskas BC (2014) Patterns of breast magnetic resonance imaging use in community practice. JAMA Intern Med 174(1):125–132. doi:10.1001/jamainternmed.2013.11963

    Article  PubMed  PubMed Central  Google Scholar 

  27. Basu NN, Ross GL, Evans DG, Barr L (2015) The Manchester guidelines for contralateral risk-reducing mastectomy. World J Surg Oncol 13:237. doi:10.1186/s12957-015-0638-y

    Article  PubMed  PubMed Central  Google Scholar 

  28. Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, Geller BM, Abraham LA, Taplin SH, Dignan M, Cutter G, Ballard-Barbash R (2003) Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med 138(3):168–175

    Article  PubMed  Google Scholar 

  29. Woloshin S, Schwartz LM (2010) The benefits and harms of mammography screening: understanding the trade-offs. JAMA 303(2):164–165. doi:10.1001/jama.2009.2007

    Article  CAS  PubMed  Google Scholar 

  30. Hubbard RA, Kerlikowske K, Flowers CI, Yankaskas BC, Zhu W, Miglioretti DL (2011) Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study. Ann Intern Med 155(8):481–492. doi:10.7326/0003-4819-155-8-201110180-00004

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP (2006) Rate of over-diagnosis of breast cancer 15 years after end of Malmo mammographic screening trial: follow-up study. BMJ 332(7543):689–692. doi:10.1136/bmj.38764.572569.7C

    Article  PubMed  PubMed Central  Google Scholar 

  32. Houssami N, Abraham LA, Miglioretti DL, Sickles EA, Kerlikowske K, Buist DS, Geller BM, Muss HB, Irwig L (2011) Accuracy and outcomes of screening mammography in women with a personal history of early-stage breast cancer. JAMA 305(8):790–799. doi:10.1001/jama.2011.188

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Lehman CD, Lee JM, DeMartini WB, Hippe DS, Rendi MH, Kalish G, Porter P, Gralow J, Partridge SC (2016) Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst 108(3):djv349. doi:10.1093/jnci/djv349

    Article  PubMed  Google Scholar 

  34. Weinstock C, Campassi C, Goloubeva O, Wooten K, Kesmodel S, Bellevance E, Feigenberg S, Ioffe O, Tkaczuk KH (2015) Breast magnetic resonance imaging (MRI) surveillance in breast cancer survivors. Springerplus 4:459. doi:10.1186/s40064-015-1158-5

    Article  PubMed  PubMed Central  Google Scholar 

  35. Gweon HM, Cho N, Han W, Yi A, Moon HG, Noh DY, Moon WK (2014) Breast MR imaging screening in women with a history of breast conservation therapy. Radiology 272(2):366–373. doi:10.1148/radiol.14131893

    Article  PubMed  Google Scholar 

  36. Chowdhury M, Euhus D, Onega T, Biswas S, Choudhary PK (2017) A model for individualized risk prediction of contralateral breast cancer. Breast Cancer Res Treat 161(1):153–160. doi:10.1007/s10549-016-4039-x

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, University of California, Los Angeles, 1223 16th Street, Suite 1100, Santa Monica, CA, 90404, USA

    John V. Hegde, Joanne B. Weidhaas, Michael L. Steinberg & Susan A. McCloskey

  2. Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Xiaoyan Wang

  3. Department of Surgery, University of California, Los Angeles, Los Angeles, CA, USA

    Deanna J. Attai, Maggie L. DiNome & Amy Kusske

  4. Department of Radiology, University of California, Los Angeles, Los Angeles, CA, USA

    Anne C. Hoyt

  5. Division of Hematology/Oncology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Sara A. Hurvitz

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  1. John V. Hegde
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Correspondence to Susan A. McCloskey.

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Conflict of interest

Dr. Hurvitz reports research funding unrelated to this work from Amgen, Bayer, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Pfizer, Roche, Biomarin, Merrimack, PUMA, Dignitana, Medivation, Eli Lilly, Novartis, and OBI Pharma. She also reports travel funding from Eli Lilly, Novartis, and OBI Pharma.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Hegde, J.V., Wang, X., Attai, D.J. et al. Predictors associated with MRI surveillance screening in women with a personal history of unilateral breast cancer but without a genetic predisposition for future contralateral breast cancer. Breast Cancer Res Treat 166, 145–156 (2017). https://doi.org/10.1007/s10549-017-4392-4

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  • DOI: https://doi.org/10.1007/s10549-017-4392-4

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