Magnetic resonance imaging in screening women at high risk of breast cancer: A meta-analysis

Abstract

Background: Magnetic resonance imaging (MRI) is more accurate than mammography in screening for breast cancer. Exposure to ionizing radiation from repeated diagnostic X-rays may be a cause of breast cancer.Methods: We conducted systematic searches on PubMed, Cochrane and Embase to identify studies on women who underwent mammography or MRI screening. A meta-analysis was performed to compare the detection rate of breast cancer by mammography, MRI or both.Results: A total of 18 diagnostic publications were identified and included in the meta-analysis. Among the 1000 screened women, MRI alone increased the detection rate of breast cancer by 8 compared with mammography alone (RR 0.48, 95% CI 0.42-0.54), and MRI plus mammography increased the detection rate of breast cancer by 1 compared with MRI alone (RR 0.86, 95% CI 0.78-0.96). Subgroup analysis demonstrated that the diagnostic efficacy of MRI plus mammography in breast was obviously better than that of MRI alone or mammography alone.Conclusions: Screening with MRI alone might be the best choice for women at high risk of breast cancer.Abbreviations: BRCA1/2 = breast cancer susceptibility gene 1/2, CDR = cancer detection rate, DCIS = ductal carcinoma in situ, MG = mammography, MRI = magnetic resonance imaging, RR = risk ratio.

Case report: Possible role of low-dose PEM for avoiding unneeded procedures associated with false-positive or equivocal breast MRI results

“…Although very sensitive for detecting breast abnormalities before the occurrence of late-stage progression and increasing metastasis-free survival rates ( 4 , 6 ), contrast-enhanced breast MRI has a number of significant drawbacks ( 7 ). These include a high false-positive rate and high sensitivity to hormonal changes, which can result in imaging uncertainty ( 8 – 10 ). These issues contribute to increasing the number of non-cancerous biopsies and may cause overdiagnosis.…”

Hallazgos en resonancia magnética nuclear y anatomía patológica en especímenes de mastectomía y ganglios linfáticos axilares de pacientes con cáncer de mama

“…Revisiones sistemáticas de la literatura han concluido la indiscutible ventaja de la resonancia magnética nuclear (RMN) en este contexto. También, se ha demostrado la alta sensibilidad, especificidad y baja tasa de falsos negativos en estadios iniciales y en pacientes con alto riesgo de malignidad 13,16,17 . La resonancia magnética nuclear (RMN) es la herramienta más sensible (95-100%) en la detección de lesiones malignas inaparentes y fue superior a otros estudios en la detección de cáncer de mama 13,17-20 .…”

Clinical genetics in breast cancer

“…11,25 However, most patients with genetic mutations may consider annual breast MRI, in addition to an annual mammogram, while others may consider risk reducing mastectomies and/or risk reducing medications. 11 Although a recent meta-analysis reaffirmed the utility of the dual mammogram and MRI imaging protocol, 26 there may be room for improvement in regard to the optimal surveillance regimen. For example, a study by Guindalini et al demonstrated that biannual MRI may be sufficient for younger patients with BRCA1 mutations.…”