Breast Cancer Research and Treatment

, Volume 100, Issue 1, pp 109–119 | Cite as

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

  • Mieke Kriege
  • Cecile T. M. Brekelmans
  • Inge Marie Obdeijn
  • Carla Boetes
  • Harmine M. Zonderland
  • Sara H. Muller
  • Theo Kok
  • Radu A. Manoliu
  • A. Peter E. Besnard
  • Madeleine M. A. Tilanus-Linthorst
  • Caroline Seynaeve
  • Carina C. M. Bartels
  • Reini Kaas
  • Siebren Meijer
  • Jan C. Oosterwijk
  • Nicoline Hoogerbrugge
  • Rob A. E. M. Tollenaar
  • Emiel J. T. Rutgers
  • Harry J. de Koning
  • Jan G. M. Klijn



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.


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).


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

Key words

Age BRCA1 BRCA2 Breast cancer screening Breast density Mammography Menopausal status MRI Sensitivity Specificity 


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


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Copyright information

© Springer Science+Business Media B. V. 2006 2006

Authors and Affiliations

  • Mieke Kriege
    • 1
  • Cecile T. M. Brekelmans
    • 1
  • Inge Marie Obdeijn
    • 2
  • Carla Boetes
    • 3
  • Harmine M. Zonderland
    • 4
  • Sara H. Muller
    • 5
  • Theo Kok
    • 6
  • Radu A. Manoliu
    • 7
  • A. Peter E. Besnard
    • 5
  • Madeleine M. A. Tilanus-Linthorst
    • 8
  • Caroline Seynaeve
    • 1
  • Carina C. M. Bartels
    • 8
  • Reini Kaas
    • 9
  • Siebren Meijer
    • 10
  • Jan C. Oosterwijk
    • 11
  • Nicoline Hoogerbrugge
    • 12
  • Rob A. E. M. Tollenaar
    • 13
  • Emiel J. T. Rutgers
    • 9
  • Harry J. de Koning
    • 14
  • Jan G. M. Klijn
    • 1
  1. 1.Family Cancer Clinic, Department of Medical OncologyErasmus MC-Daniel den Hoed Cancer CenterRotterdamthe Netherlands
  2. 2.Family Cancer Clinic, Department of RadiologyErasmus MC-Daniel den Hoed Cancer CenterRotterdamthe Netherlands
  3. 3.Department of RadiologyUniversity Medical CenterNijmegenthe Netherlands
  4. 4.Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
  5. 5.Department of RadiologyNetherlands Cancer InstituteAmsterdamthe Netherlands
  6. 6.Department of RadiologyUniversity Medical Center, University of GroningenGroningenthe Netherlands
  7. 7.Department of RadiologyVU University Medical CenterAmsterdamthe Netherlands
  8. 8.Family Cancer Clinic, Department of SurgeryErasmus MC-Daniel den Hoed Cancer CenterRotterdamthe Netherlands
  9. 9.Department of SurgeryNetherlands Cancer InstituteAmsterdamthe Netherlands
  10. 10.Department of SurgeryVU University Medical CenterAmsterdamthe Netherlands
  11. 11.Department of Clinical GeneticsUniversity Medical Center, University of GroningenGroningenthe Netherlands
  12. 12.Family Cancer ClinicUniversity Medical CenterNijmegenthe Netherlands
  13. 13.Department of SurgeryLeiden University Medical CenterLeidenthe Netherlands
  14. 14.Department of Public HealthErasmus MCRotterdamthe Netherlands

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