Breast Cancer Research and Treatment

, Volume 145, Issue 3, pp 663–672

MRI breast screening in high-risk women: cancer detection and survival analysis

  • Evans D. Gareth
  • Kesavan Nisha
  • Lim Yit
  • Gadde Soujanye
  • Hurley Emma
  • Nathalie J. Massat
  • Anthony J. Maxwell
  • Ingham Sarah
  • Eeles Rosalind
  • Martin O. Leach
  • MARIBS Group
  • Howell Anthony
  • Duffy Stephen
Clinical trial

Abstract

Women with a genetic predisposition to breast cancer tend to develop the disease at a younger age with denser breasts making mammography screening less effective. The introduction of magnetic resonance imaging (MRI) for familial breast cancer screening programs in recent years was intended to improve outcomes in these women. We aimed to assess whether introduction of MRI surveillance improves 5- and 10-year survival of high-risk women and determine the accuracy of MRI breast cancer detection compared with mammography-only or no enhanced surveillance and compare size and pathology of cancers detected in women screened with MRI + mammography and mammography only. We used data from two prospective studies where asymptomatic women with a very high breast cancer risk were screened by either mammography alone or with MRI also compared with BRCA1/2 carriers with no intensive surveillance. 63 cancers were detected in women receiving MRI + mammography and 76 in women receiving mammography only. Sensitivity of MRI + mammography was 93 % with 63 % specificity. Fewer cancers detected on MRI were lymph node positive compared to mammography/no additional screening. There were no differences in 10-year survival between the MRI + mammography and mammography-only groups, but survival was significantly higher in the MRI-screened group (95.3 %) compared to no intensive screening (73.7 %; p = 0.002). There were no deaths among the 21 BRCA2 carriers receiving MRI. There appears to be benefit from screening with MRI, particularly in BRCA2 carriers. Extended follow-up of larger numbers of high-risk women is required to assess long-term survival.

Keywords

MRI Breast cancer BRCA1 BRCA2, survival 

Supplementary material

10549_2014_2931_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Evans D. Gareth
    • 2
    • 3
    • 4
  • Kesavan Nisha
    • 1
    • 2
  • Lim Yit
    • 1
  • Gadde Soujanye
    • 1
  • Hurley Emma
    • 1
  • Nathalie J. Massat
    • 5
  • Anthony J. Maxwell
    • 1
  • Ingham Sarah
    • 2
  • Eeles Rosalind
    • 7
  • Martin O. Leach
    • 6
  • MARIBS Group
  • Howell Anthony
    • 2
    • 4
  • Duffy Stephen
    • 5
  1. 1.Department of Breast Imaging, Nightingale CentreUniversity Hospital of South Manchester NHS Foundation TrustWythenshawe, ManchesterUK
  2. 2.Genesis Breast Cancer Prevention CentreUniversity Hospital of South Manchester NHS Foundation TrustWythenshawe, ManchesterUK
  3. 3.Manchester University Department of Genomic Medicine, Manchester Academic Health Science Centre, Central Manchester Foundation TrustSt. Mary’s HospitalManchesterUK
  4. 4.Manchester Breast Centre, Manchester Cancer Research Centre, Christie HospitalUniversity of ManchesterWithington, ManchesterUK
  5. 5.Centre for Cancer Prevention, Wolfson Institute of Preventive MedicineQueen Mary University of LondonLondonUK
  6. 6.CRUK Cancer Imaging CentreThe Institute of Cancer Research and Royal Marsden NHS Foundation TrustSuttonUK
  7. 7.Oncogenetics Team, Division of Genetics and EpidemiologyThe Institute of Cancer Research and Royal Marsden NHS Foundation TrustSuttonUK

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