Abstract
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%; P = 0.02) and tended to be more often ≤1 cm (58 vs. 31%; P = 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.
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References
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
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
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
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
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
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
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
Rijnsburger AJ (2006) Effects and costs of breast cancer screening in women with a familial or gentic predisposition (thesis)
Hilleren DJ, Andersson IT, Lindholm K et al (1991) Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology 178:149–154
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
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
Meyer JE, Amin E, Lindfors KK et al (1989) Medullary carcinoma of the breast: mammographic and US appearance. Radiology 170:79–82
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
Kneeshaw PJ, Turnbull LW, Drew PJ (2003) Current applications and future direction of MR mammography. Br J Cancer 88:4–10
Kinkel K, Hylton NM (2001) Challenges to interpretation of breast MRI. J Magn Reson Imaging 13:821–829
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
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
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
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
Gilles R, Guinebretiere JM, Lucidarme O et al (1994) Nonpalpable breast tumors: diagnosis with contrast- enhanced subtraction dynamic MR imaging. Radiology 191:625–631
Morris EA (2003) Screening for breast cancer with MRI. Semin Ultrasound CT MR 24:45–54
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
Claus EB, Risch NJ, Thompson WD (1994) Autosomal dominant inheritance of early-onset breast cancer. Cancer 73:643–651
American College of Radiology (1998) Illustrated breast imaging reporting and data system (BI-RADS) Atlas. 3rd edn. Reston, VA
Liberman L, Menell JH (2002) Breast imaging reporting and data system (BI-RADS). Radiol Clin North Am 40:409–430
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
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
Acknowledgements
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.
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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). https://doi.org/10.1007/s10549-006-9341-6
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DOI: https://doi.org/10.1007/s10549-006-9341-6