Breast Cancer Screening With Mammography Plus Ultrasonography or Magnetic Resonance Imaging in Women 50 Years or Younger at Diagnosis and Treated With Breast Conservation Therapy

Cho, Nariya; Han, Wonshik; Han, Boo‐Kyung; Bae, Min Sun; Ko, Eun Sook; Nam, Seok Jin; Chae, Eun Young; Lee, Jong Won; Kim, Sung Hun; Kang, Bong Joo; Song, Byung Joo; Kim, Min Jung; Moon, Hee Jung; Kim, Kyung Sik; Kim, Sun Mi; Kang, Eunyoung; Choi, Yunhee; Kim, Hak Hee; Moon, Woo Kyung

doi:10.1001/jamaoncol.2017.1256

Cited by 126 publications

(99 citation statements)

References 39 publications

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“…The most commonly used supplemental test is without doubt mammography, as the postulate has long been reversed (MRI was regarded as a supplemental test to mammography). It is important to realize that this is no longer true, even when studies are still presenting MRI as a supplemental test . The incremental cancer detection with mammography ranges from 0–19.4% .…”

Section: Supplemental Screening Techniquesmentioning

confidence: 99%

“…Specificities for MRI screening in this population are relatively high (albeit still somewhat lower than for mammography). However, in women with a personal history of breast cancer breast imaging reporting and data system (BI‐RADS) 3 evaluations, ie, likely benign findings with less than 2% risk of being malignant, are rather common . In the early phase after surgery this may be due to radiotherapy, causing some focal residual enhancement in the breast that requires follow‐up imaging .…”

Section: Developing Indications For Breast Mri Screeningmentioning

confidence: 99%

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Contrast‐enhanced MRI for breast cancer screening

Mann

Kuhl²,

Moy

2019

Magnetic Resonance Imaging

249

154

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Multiple studies in the first decade of the 21st century have established contrast‐enhanced breast MRI as a screening modality for women with a hereditary or familial increased risk for the development of breast cancer. In recent studies, in women with various risk profiles, the sensitivity ranges between 81% and 100%, which is approximately twice as high as the sensitivity of mammography. The specificity increases in follow‐up rounds to around 97%, with positive predictive values for biopsy in the same range as for mammography. MRI preferentially detects the more aggressive/invasive types of breast cancer, but has a higher sensitivity than mammography for any type of cancer. This performance implies that in women screened with breast MRI, all other examinations must be regarded as supplemental. Mammography may yield ~5% additional cancers, mostly ductal carcinoma in situ, while slightly decreasing specificity and increasing the costs. Ultrasound has no supplemental value when MRI is used. Evidence is mounting that in other groups of women the performance of MRI is likewise superior to more conventional screening techniques. Particularly in women with a personal history of breast cancer, the gain seems to be high, but also in women with a biopsy history of lobular carcinoma in situ and even women at average risk, similar results are reported. Initial outcome studies show that breast MRI detects cancer earlier, which induces a stage‐shift increasing the survival benefit of screening. Cost‐effectiveness is still an issue, particularly for women at lower risk. Since costs of the MRI scan itself are a driving factor, efforts to reduce these costs are essential. The use of abbreviated MRI protocols may enable more widespread use of breast MRI for screening. Level of Evidence: 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:377–390.

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Section: Supplemental Screening Techniquesmentioning

confidence: 99%

Section: Developing Indications For Breast Mri Screeningmentioning

confidence: 99%

Contrast‐enhanced MRI for breast cancer screening

Mann

Kuhl²,

Moy

2019

Magnetic Resonance Imaging

249

154

View full text Add to dashboard Cite

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“…Physical examination and mammography were performed as the methods to detect IBTR in our institute. If postoperative breast ultrasonography was performed annually, the proportion of small IBTR might increase [32] . Our study has several limitations including the fact that it was a retrospective small single-institute study, the loss of primary tumor information, and its inclusion of a mixed population with or without adjuvant chemotherapy after IBTR, despite adding adjuvant chemotherapy to the adjusting covariate factors in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

pTis and pT1a Ipsilateral Breast Tumor Recurrence Is Associated with Good Prognosis after Salvage Surgery

Ishitobi

Fukui²,

Hashimoto³

et al. 2017

Oncology

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Objectives: Patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery have a poor prognosis. There is little information regarding the prognostic impact of the tumor size in patients with IBTR. Methods: A total of 143 patients who had histologically confirmed IBTR without distant metastases and who underwent salvage surgery between 1989 and 2013 in our hospital were included. Distant disease-free survival (DDFS) was calculated according to the invasive tumor size of IBTR. The median follow-up period was 4.6 years. Results: Patients with pT1b or more advanced IBTR have a high (≥20%) 5-year distant recurrence risk. There were significant differences in DDFS between patients with pTis or pT1a and those with pT1b or a more advanced stage (5-year DDFS: 94.4 vs. 70.1%, respectively, p value = 0.006). This significance remained after adjusting for other clinicopathological factors (p value = 0.04). Conclusion: Patients with pTis or pT1a IBTR have a good prognosis after salvage surgery for IBTR, and the omission of adjuvant chemotherapy could be considered. Further research and validation studies are needed.

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“…Breast magnetic resonance imaging (MRI) combined with mammography has been reported to be 90% to 100% sensitive in detecting breast cancer. Its usefulness has been reported not only in high-risk screening but also in pre-operative examination, evaluation of neoadjuvant chemotherapy response, and post-operative screening (2)(3)(4)(5). The use of breast MRI has been rapidly growing in Korea for the last 10 years.…”

Section: Introductionmentioning

confidence: 99%