Breast MRI Screening of Women With a Personal History of Breast Cancer

Brennan, Sandra; Liberman, Laura; Dershaw, D. David; Morris, Elizabeth A.

doi:10.2214/ajr.09.3573

Cited by 145 publications

(69 citation statements)

References 26 publications

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“…Relative reduction in false-positive findings in women with a personal history of breast cancer has also been observed with MR imaging screening (15)(16)(17). Reduction in both background parenchymal enhancement and cystic change at MR imaging have been noted in the previously irradiated breast (18).…”

Section: Discussionmentioning

confidence: 85%

Multiple Bilateral Circumscribed Masses at Screening Breast US: Consider Annual Follow-up

Berg¹,

Zhang²,

Cormack³

et al. 2013

Radiology

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Purpose:To determine prospectively the prevalence and rate of malignancy of multiple bilateral (MB) circumscribed breast masses detected at screening ultrasonography (US) compared with those of other US-depicted masses. Materials and Methods:This institutional review board-approved, HIPAA-compliant prospective trial included women at elevated risk for breast cancer, who gave written informed consent to participate in a study evaluating cancer detection rates for three rounds of annual supplemental screening US at 21 international sites. After exclusions, 2662 participants and 7473 screening studies were included. Physicianperformed US studies were interpreted, with blinding to mammography results. Simple cysts were noted. Breast Imaging Reporting and Data System features of all other findings were recorded, with addition of the descriptor MB similar-appearing circumscribed masses (minimum of three total and at least one in each breast), with details of the largest such mass recorded. Rates of malignancy were determined after biopsy or mammographic and US follow-up at a minimum of 11 months. For this analysis, 490 women (1370 screenings) with prior mastectomy were excluded. Descriptive statistics and exact 95% confidence intervals (CIs) were generated. Results:Of 2172 evaluable participants (6103 screening studies; median age at study entry, 54.0 years; range, 25-91 years), 1454 had unique findings at US. One hundred thirty-five (6.2%) participants had 153 unique MB circumscribed masses, with no malignancies (0% [95% CI: 0%, 2.4%]; 95% CI: 0%, 2.9% for the 127 masses with at least 2 years of follow-up). There were 1319 (60.7%) participants with 2464 non-MB lesions, including 1038 solitary circumscribed masses with a malignancy rate of 0.8% (eight of 1038). Of 836 solitary circumscribed masses with at least 2 years of follow-up, the malignancy rate was 0.4% (three of 836; 95% CI: 0.1%, 1.0%). Of the 135 women with MB circumscribed masses, 82 (60.7%) also had a solitary lesion. Two of these 82 women (2.4%) had cancer. Conclusion:MB similar-appearing circumscribed masses seen at screening US are almost always benign, with no malignancies found among such lesions in this prospective, multicenter experience. These lesions are suitable for diagnostic follow-up in 1 year, with resumption of screening thereafter if they are stable.q RSNA, 2013

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Section: Discussionmentioning

confidence: 85%

Multiple Bilateral Circumscribed Masses at Screening Breast US: Consider Annual Follow-up

Berg¹,

Zhang²,

Cormack³

et al. 2013

Radiology

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“…Throughout the study period, breast MRI and PET were used quite rarely, with a slight secular trend showing increased use over time. The use of breast MRI in women with prior breast cancer is the subject of ongoing investigation [27].…”

Section: Discussionmentioning

confidence: 99%

Use of high technology imaging for surveillance of early stage breast cancer

Panageas

Sima

Liberman

et al. 2011

Breast Cancer Res Treat

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Guidelines do not support utilization of high technology radiologic imaging (HTRI) for surveillance after curative treatment for early stage breast cancer. Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data were used to identify 25,555 women diagnosed with stage I-II breast cancer between 1998 and 2003 who survived ≥ 48 months from diagnosis without evidence of second primary or recurrent cancer in this interval. HTRI utilization (computerized tomography scanning (CT), bone scan (BS), breast magnetic resonance imaging, and positron emission tomography scans) was measured in months 13-48 post-diagnosis. Cases were individually matched to 75,669 female Medicare enrollees without cancer. Factors associated with HTRI utilization were evaluated. Forty percent of women with stage I-II breast cancer and 25% of controls had ≥ 1 HTRI during the surveillance interval (P < 0.001). High utilization rates were observed for CT (30%) and BSs (19%). The proportion of women who had a CT during the surveillance period increased in both cancer survivors and controls. Among breast cancer cases age <80, higher comorbidity index, stage II disease, and more recent diagnosis were independently associated with receipt of HTRI. Paralleling patterns observed in controls, HTRI utilization for surveillance following diagnosis of early stage breast cancer has steadily increased among Medicare beneficiaries. Strategies to foster judicious utilization of HTRI should be a priority.

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“…48,49 For example, in a retrospective study of 1,699 patients with a personal history of breast cancer and no other risk factors, Brennan et al 50 observed a cancer-detection rate of 12%, of which 59% were detected by MRI alone. MRI screening in this study yielded a positive predictive value of 39%, and the authors concluded that a definite benefit to its use exists in this population.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…MRI screening in this study yielded a positive predictive value of 39%, and the authors concluded that a definite benefit to its use exists in this population. 50 Benefits of MRI screening should be weighed against risks and limitations such as cost. Saadatmand et al 51 performed a large, prospective study evaluating use of MRI screening in patients with familial risk factors and an estimated lifetime risk of breast cancer that was higher than 15%.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

et al. 2017

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Breast MRI Screening of Women With a Personal History of Breast Cancer

Abstract: We found that breast MRI screening of women with only a personal history of breast cancer was clinically valuable finding malignancies in 12%, with a reasonable biopsy rate (PPV, 39%).

Cited by 145 publications

References 26 publications

Multiple Bilateral Circumscribed Masses at Screening Breast US: Consider Annual Follow-up

Multiple Bilateral Circumscribed Masses at Screening Breast US: Consider Annual Follow-up

Use of high technology imaging for surveillance of early stage breast cancer

Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer

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