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Breast MRI Screening for the Intermediate Risk: An Open Issue

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Breast MRI for High-risk Screening

Abstract

Intermediate risk concerns up to 25% of women, mainly with (1) personal history of invasive or ductal in situ breast cancer (see Chap. 22), (2) previous biopsy-proven atypical ductal hyperplasia (ADH) or lobular neoplasia (LN), or (3) family history below high risk. For status after ADH or LN, five retrospective studies, only two with a control group, could be identified. Breast cancer yield was 1.1–1.8%. Overall, these studies could not prove a significant benefit of MRI concerning earlier detection. However, MRI was associated with high rates of biopsy (7.8–11.5%) or 6-month follow-up (8.8–16.0%) recommendations. Even though women at intermediate family risk are included in some publications on high-risk screening (based on the patient mix and the study design), neither these studies nor a prospective multicenter study in women with dense tissue at high or intermediate risk allows conclusions concerning a prognostic effect in women at intermediate risk. Thus, existing international recommendations remain valid: based on lacking evidence in favor of these indications, MRI surveillance cannot be generally recommended for women at intermediate risk. Hopes concern improvement of technique and diagnostic criteria and availability of more reliable data from presently starting prospective studies.

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Notes

  1. 1.

    Most data are based on ACR classifications 1–4. The modified ACR classifications a–d was issued in 2013 by the American College of Radiology (acr.org).

Abbreviations

ACS:

American Cancer Society

ADH:

Atypical ductal hyperplasia

ALH:

Atypical lobular hyperplasia

DCIS:

Ductal carcinoma in situ

EUSOBI:

European Society of Breast Imaging

IARC:

International Agency for Research on Cancer

LCIS:

Lobular carcinoma in situ

LN:

Lobular neoplasia

MRI:

Magnetic resonance imaging

US:

Ultrasound, ultrasonography

References

  1. Passaperuma K, Warner E, Causer PA et al (2012) Long-term results of screening with magnetic resonance imaging in women with BRCA mutations. Br J Cancer 107:24–30

    Article  CAS  Google Scholar 

  2. Lauby-Secretan B, Loomis D, Straif K (2015) International Agency for Research on Cancer Handbook Working Group. Breast-Cancer Screening—Viewpoint of the IARC Working Group. N Engl J Med 372:2353–2358

    Article  CAS  Google Scholar 

  3. International Agency for Research on Cancer (2016) IARC handbooks of cancer prevention. Vol. 15. Breast cancer screening. IARC Press, Lyon, France. http://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Breast-Cancer-Screening-2016. Accessed 30 Jun

  4. Oeffinger KC, Fontham ET, Etzioni R et al; American Cancer Society (2015) Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 314:1599–1614

    Article  Google Scholar 

  5. Sardanelli F, Aase HS, Álvarez M et al (2017) Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey. Eur Radiol 27:2737–2743

    Article  Google Scholar 

  6. Tabár L, Yen AM, Wu WY et al (2015) Insights from the breast cancer screening trials: how screening affects the natural history of breast cancer and implications for evaluating service screening programs. Breast 21(1):13–20

    Article  Google Scholar 

  7. Miglioretti DL, Zhu W, Kerlikowske K et al; Breast Cancer Surveillance Consortium (2015) Breast tumor prognostic characteristics and biennial vs annual mammography, age, and menopausal status. JAMA Oncol 1(8):1069–1077

    Article  Google Scholar 

  8. Melnikow J, Fenton JJ, Whitlock EP et al (2016) Supplemental screening for breast cancer in women with dense breasts: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 164:268–278

    Article  Google Scholar 

  9. Gail MH, Mai PL (2010) Comparing breast cancer risk assessment models. J Natl Cancer Inst 102:665–668

    Article  Google Scholar 

  10. Brentnall AR, Harkness EF, Astley SM et al (2015) Mammographic density adds accuracy to both the Tyrer-Cuzick and Gail breast cancer risk models in a prospective UK screening cohort. Breast Cancer Res 17:147

    Article  Google Scholar 

  11. Gastounioti A, Conant EF, Kontos D (2016) Beyond breast density: a review on the advancing role of parenchymal texture analysis in breast cancer risk assessment. Breast Cancer Res 18:91

    Article  Google Scholar 

  12. Mandelson MT, Oestreicher N, Porter PL et al (2000) Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 92:1081–1087

    Article  CAS  Google Scholar 

  13. Weigel S, Heindel W, Heidrich J, Hense HW, Heidinger O (2017) Digital mammography screening: sensitivity of the programme dependent on breast density. Eur Radiol 27:2744–2751

    Article  Google Scholar 

  14. Houssami N, Abraham LA, Onega T et al (2014) Accuracy of screening mammography in women with a history of lobular carcinoma in situ or atypical hyperplasia of the breast. Breast Cancer Res Treat 145:765–773

    Article  Google Scholar 

  15. Van de Vijver MJ (2005) Biological variables and prognosis of DCIS. Breast 14:509–519

    Article  Google Scholar 

  16. Menes TS, Kerlikowske K, Lange J, Jaffer S, Rosenberg R, Miglioretti DL (2017) Subsequent breast cancer risk following diagnosis of atypical ductal hyperplasia on needle biopsy. JAMA Oncol 3:36–41

    Article  Google Scholar 

  17. Rendi MH, Dintzis SM, Lehman CD, Calhoun KE, Allison KH (2012) Lobular in-situ neoplasia on breast core needle biopsy: imaging indication and pathologic extent can identify which patients require excisional biopsy. Ann Surg Oncol 19:914–921

    Article  Google Scholar 

  18. Perlet C, Heywang-Kobrunner SH, Heinig A et al (2006) Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer 106:982–990

    Article  Google Scholar 

  19. Port ER, Park A, Borgen PI, Morris E, Montgomery LL (2007) Results of MRI screening for breast cancer in high-risk patients with LCIS and atypical hyperplasia. Ann Surg Oncol 14:1051–1057

    Article  Google Scholar 

  20. Friedlander LC, Roth SO, Gavenonis SC (2011) Results of MRI screening for breast cancer in high risk patients with LCIS. Radiology 261:421–427

    Article  Google Scholar 

  21. Sung JS, Malak SF, Bajaj P, Alis R, Dershaw DD, Morris EA (2011) Screening breast MR imaging in women with a history of lobular carcinoma in situ. Radiology 261:414–420

    Article  Google Scholar 

  22. Schwartz T, Cyr A, Margenthaler J (2015) Screening breast magnetic resonance imaging in women with atypia or lobular carcinoma in situ. J Surg Res 193:519–522

    Article  Google Scholar 

  23. King TA, Muhsen S, Patil S et al (2013) Is there a role for routine screening MRI in women with LCIS? Breast Cancer Res Treat 142:445–453

    Article  Google Scholar 

  24. Nelson HD, Zakher B, Cantor A et al (2012) Risk factors for breast cancer for women age 40 to 49: a systemic review and meta-analysis. Ann Intern Med 156(9):635–648

    Article  Google Scholar 

  25. Berg WA, Zhang Z, Lehrer D et al (2012) Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA 307:1394–1404

    Article  CAS  Google Scholar 

  26. Monticciolo DL, Newell MS, Moy L, Niell B, Monsees B, Sickles EA (2018) Breast cancer screening in women at higher-than-average risk: recommendations from the ACR. J Am Coll Radiol 15:408–414

    Article  Google Scholar 

  27. National Comprehensive Cancer Network (NCCN) (2018) NCCN-Guideline for breast cancer screening and diagnosis. Version 2.2018—May 18. https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf. Accessed 30 Jun 2020

  28. Health Quality Ontario (2016) Magnetic resonance imaging as an adjunct to mammography for breast cancer screening in women at less than high risk for breast cancer: a health technology assessment. Ont Health Technol Assess Ser 16(20):1–30. http://www.hqontario.ca/evidence-to-improve-care/journal-ontario-health-technology-assessment-series. Accessed 30 Jun 2020

  29. Emaus MJ, Bakker MF, Peeters PH et al (2015) MR imaging as an additional screening modality for the detection of breast cancer in women aged 50–75 years with extremely dense breasts: the DENSE trial study design. Radiology 277:527–537

    Article  Google Scholar 

  30. Saadatmand S, Rutgers EJ, Tollenaar RA et al (2012) Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc): a multicentre randomized controlled trial. BMC Cancer 12:440

    Article  Google Scholar 

  31. Panizza P, Viganò S, Bonelli L et al (2012) Screening women at intermediate risk: harm or charm? Eur J Radiol 81(Suppl 1):S116–S117

    Article  Google Scholar 

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Authors and Affiliations

  1. Referenzzentrum Mammographie Munchen and FFB gGmbH, Munich, Germany

    Sylvia H. Heywang-Köbrunner & Astrid Hacker

Authors
  1. Sylvia H. Heywang-Köbrunner
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  2. Astrid Hacker
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Corresponding author

Correspondence to Sylvia H. Heywang-Köbrunner .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy

    Francesco Sardanelli

  2. Department of Cell Biology and Neurosciences Molecular and Cellular Imaging Unit, Istituto Superiore di Sanità (ISS), Rome, Italy

    Franca Podo

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Heywang-Köbrunner, S.H., Hacker, A. (2020). Breast MRI Screening for the Intermediate Risk: An Open Issue. In: Sardanelli, F., Podo, F. (eds) Breast MRI for High-risk Screening. Springer, Cham. https://doi.org/10.1007/978-3-030-41207-4_22

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  • DOI: https://doi.org/10.1007/978-3-030-41207-4_22

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  • Online ISBN: 978-3-030-41207-4

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