Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

  • Inge-Marie A. Obdeijn
  • Claudette E. Loo
  • Adriana J. Rijnsburger
  • Martin N. J. M. Wasser
  • Elisabeth Bergers
  • Theo Kok
  • Jan G. M. Klijn
  • Carla Boetes
Clinical trial

Abstract

In order to assess the characteristics of malignant breast lesions those were not detected during screening by MR imaging. In the Dutch MRI screening study (MRISC), a non-randomized prospective multicenter study, women with high familial risk or a genetic predisposition for breast cancer were screened once a year by mammography and MRI and every 6 months with a clinical breast examination (CBE). The false-negative MR examinations were subject of this study and were retrospectively reviewed by two experienced radiologists. From November 1999 until March 2006, 2,157 women were eligible for study analyses. Ninety-seven malignant breast tumors were detected, including 19 DCIS (20%). In 22 patients with a malignant lesion, the MRI was assessed as BI-RADS 1 or 2. One patient was excluded because the examinations were not available for review. Forty-three percent (9/21) of the false-negative MR cases concerned pure ductal carcinoma in situ (DCIS) or DCIS with invasive foci, in eight of them no enhancement was seen at the review. In six patients the features of malignancy were missed or misinterpreted. Small lesion size (n = 3), extensive diffuse contrast enhancement of the breast parenchyma (n = 2), and a technically inadequate examination (n = 1) were other causes of the missed diagnosis. A major part of the false-negative MR diagnoses concerned non-enhancing DCIS, underlining the necessity of screening not only with MRI but also with mammography. Improvement of MRI scanning protocols may increase the detection rate of DCIS. The missed and misinterpreted cases are reflecting the learning curve of a multicenter study.

Keywords

Breast cancer MRI Screening Hereditary 

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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Inge-Marie A. Obdeijn
    • 1
  • Claudette E. Loo
    • 2
  • Adriana J. Rijnsburger
    • 3
  • Martin N. J. M. Wasser
    • 4
  • Elisabeth Bergers
    • 5
  • Theo Kok
    • 6
  • Jan G. M. Klijn
    • 3
  • Carla Boetes
    • 7
    • 8
  1. 1.Department of RadiologyErasmus MC-Daniel den Hoed Cancer CenterRotterdamThe Netherlands
  2. 2.Department of Radiology, Netherlands Cancer InstituteAntoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  3. 3.Department of Medical Oncology, Family Cancer ClinicErasmus MC-Daniel den Hoed Cancer CenterRotterdamThe Netherlands
  4. 4.Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
  5. 5.Department of RadiologyVU University Medical CenterAmsterdamThe Netherlands
  6. 6.Department of RadiologyGroningen University Medical CenterGroningenThe Netherlands
  7. 7.Department of RadiologyRadboud University Medical CenterNijmegenThe Netherlands
  8. 8.Department of RadiologyMaastricht University Medical CenterMaastrichtThe Netherlands

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