Skip to main content


Log in

Tumor characteristics and detection method in the MRISC screening program for the early detection of hereditary breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript


In the MRISC study, women with an inherited risk for breast cancer were screened by a 6-month clinical breast examination (CBE) and yearly MRI and mammography. We found that the MRISC screening scheme could facilitate early breast cancer diagnosis and that MRI was a more sensitive screening method than mammography, but less specific. In the current study we investigated the contribution of MRI in the early detection of breast cancer in relation to␣tumor characteristics. From November 1999 to October 2003, 1909 women were included and 50 breast cancers were detected, of which 45 were evaluable and included in the current study. We compared the characteristics of tumors detected by MRI-only with those of all other (non-palpable) screen-detected tumors. Further, we compared the sensitivity of mammography and MRI within subgroups according to different tumor characteristics. Twenty-two (49%) of the 45 breast cancers were detected by MRI and not visible at mammography, of which 20 (44%) were also not palpable (MRI-only detected tumors). MRI-only detected tumors were more often node-negative than other screen-detected cancers (94 vs. 59%; = 0.02) and tended to be more often ≤1 cm (58 vs. 31%; = 0.11). MRI was more sensitive than mammography for a wide spectrum of invasive tumor characteristics i.e., size, nodal status, histology, grade and ER status. Half of the breast cancers detected in this study were visible by MRI only and these tumors were smaller and significantly more often node-negative than other screen-detected tumors, suggesting that MRI makes an important contribution to the early detection of hereditary breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Kollias J, Sibbering DM, Blamey RW et al (1998) Screening women aged less than 50 years with a family history of breast cancer. Eur J Cancer 34:878–883

    Article  PubMed  CAS  Google Scholar 

  2. Brekelmans CT, Seynaeve C, Bartels CC et al (2001) Effectiveness of breast cancer surveillance in BRCA1/2 gene mutation carriers and women with high familial risk. J Clin Oncol 19:924–930

    PubMed  CAS  Google Scholar 

  3. Scheuer L, Kauff N, Robson M et al (2002) Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J Clin Oncol 20:1260–1268

    Article  PubMed  Google Scholar 

  4. Kriege M, Brekelmans CT, Boetes C et al (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J␣Med 351:427–437

    Article  PubMed  CAS  Google Scholar 

  5. Warner E, Plewes DB, Hill KA et al (2004) Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA 292:1317–1325

    Article  PubMed  CAS  Google Scholar 

  6. Leach MO, Boggis CR, Dixon AK et al (2005) Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 365:1769–1778

    Article  PubMed  CAS  Google Scholar 

  7. Kuhl CK, Schrading S, Leutner CC et al (2005) Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 23:8469–8476

    Article  PubMed  Google Scholar 

  8. Rijnsburger AJ (2006) Effects and costs of breast cancer screening in women with a familial or gentic predisposition (thesis)

  9. Hilleren DJ, Andersson IT, Lindholm K et al (1991) Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology 178:149–154

    PubMed  CAS  Google Scholar 

  10. Krecke KN, Gisvold JJ (1993) Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol 161:957–960

    PubMed  CAS  Google Scholar 

  11. Berg WA, Gutierrez L, NessAiver MS et al (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–849

    PubMed  Google Scholar 

  12. Meyer JE, Amin E, Lindfors KK et al (1989) Medullary carcinoma of the breast: mammographic and US appearance. Radiology 170:79–82

    PubMed  CAS  Google Scholar 

  13. Tabar L, Fagerberg G, Chen HH et al (1996) Tumour development, histology and grade of breast cancers: prognosis and progression. Int J Cancer 66:413–419

    Article  PubMed  CAS  Google Scholar 

  14. Kneeshaw PJ, Turnbull LW, Drew PJ (2003) Current applications and future direction of MR mammography. Br J Cancer 88:4–10

    Article  PubMed  CAS  Google Scholar 

  15. Kinkel K, Hylton NM (2001) Challenges to interpretation of breast MRI. J Magn Reson Imaging 13:821–829

    Article  PubMed  CAS  Google Scholar 

  16. Ikeda DM, Birdwell RL, Daniel BL (2001) Potential role of magnetic resonance imaging and other modalities in ductal carcinoma in situ detection. Magn Reson Imaging Clin N Am 9:345–356, vii

    Google Scholar 

  17. Neubauer H, Li M, Kuehne-Heid R et al (2003) High grade and non-high grade ductal carcinoma in situ on dynamic MR mammography: characteristic findings for signal increase and morphological pattern of enhancement. Br J Radiol 76:3–12

    Article  PubMed  CAS  Google Scholar 

  18. Boetes C, Veltman J, van Die L et al (2004) The role of MRI in invasive lobular carcinoma. Breast Cancer Res Treat 86:31–37

    Article  PubMed  Google Scholar 

  19. Rodenko GN, Harms SE, Pruneda JM et al (1996) MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J␣Roentgenol 167:1415–1419

    PubMed  CAS  Google Scholar 

  20. Gilles R, Guinebretiere JM, Lucidarme O et al (1994) Nonpalpable breast tumors: diagnosis with contrast- enhanced subtraction dynamic MR imaging. Radiology 191:625–631

    PubMed  CAS  Google Scholar 

  21. Morris EA (2003) Screening for breast cancer with MRI. Semin Ultrasound CT MR 24:45–54

    Article  PubMed  Google Scholar 

  22. Kriege M, Brekelmans CT, Boetes C et al (2001) MRI screening for breast cancer in women with familial or genetic predisposition: design of the Dutch national study (MRISC). Fam Cancer 1:163–168

    Article  PubMed  CAS  Google Scholar 

  23. Claus EB, Risch NJ, Thompson WD (1994) Autosomal dominant inheritance of early-onset breast cancer. Cancer 73:643–651

    Article  PubMed  CAS  Google Scholar 

  24. American College of Radiology (1998) Illustrated breast imaging reporting and data system (BI-RADS) Atlas. 3rd edn. Reston, VA

    Google Scholar 

  25. Liberman L, Menell JH (2002) Breast imaging reporting and data system (BI-RADS). Radiol Clin North Am 40:409–430

    Article  PubMed  Google Scholar 

  26. Lakhani SR, Jacquemier J, Sloan JP et al (1998) Multifactoral analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst 90:1138–1145

    Article  PubMed  CAS  Google Scholar 

  27. Kriege M, Brekelmans CTM, Obdeijn IM et al (2006) Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer. Breast Cancer Res Treat

Download references


Supported by grants from the Dutch Health Insurance Council (OG 98-03) and ZonMw (6200.0005). The authors thank all participants and collaborators within the MRISC study for their contribution to the study: Erasmus MC, Rotterdam: L. Aronson; P. Bos; S. van Dooren; A.N. van Geel; E.J. Meijers-Heijboer; M. Menke; A.J. Rijnsburger; A. Tibben; D. Urich; Leiden University Medical Center, Leiden: C. van Asperen; A.␣Nieborg; V.T.H.B.M. Smit; M.N.J.M. Wasser; Netherlands Cancer Institute, Amsterdam: R. Kaas; W. Koops; M. Piek-den Hartog; A. Schlief; M. van de Vijver; University Medical Center, University of Groningen: C. Dorbritz; T. van Echten; S. van Hoof, A.M. van der Vliet; J. de Vries; University Medical Center Nijmegen: J.O. Barentsz; L.V.A.M. Beex; H.␣Brunner; J.H.C.L.␣Hendriks†; M. Hogenkamp; R. Holland; M. Stoutjesdijk; A.L.M. Verbeek; M. Verhoeven; T. Wobbes; VU University Medical Center, Amsterdam: I. Groot; P.A.M.␣van Leeuwen; F.␣Menko; A. Taets van Amerongen.

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. G. M. Klijn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kriege, M., Brekelmans, C.T.M., Peterse, H. et al. Tumor characteristics and detection method in the MRISC screening program for the early detection of hereditary breast cancer. Breast Cancer Res Treat 102, 357–363 (2007).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: