Women with Personal History of Breast Cancer May Benefit from MRI

Women with a personal history of breast cancer may benefit from screening with MRI (magnetic resonance imaging) in addition to mammography. These findings were recently presented at the Radiological Society of North America (RSNA) 96th Scientific Assembly and Meeting.

The American Cancer Society (ACS) currently recommends that women with a significant genetic or family history of breast cancer (GFH)—a greater than 20% lifetime risk of developing the disease—undergo annual screening with MRI as well as mammography. Until now, however, there hasn’t been enough evidence to recommend MRI screening among women with a personal history (PH) of breast cancer.

To evaluate the performance of MRI screening among women with a PH of breast, researchers compared MRI screening outcomes among women with GFHs and PHs of the disease. A total of 1,025 women who had received MRI screening between 2004 and 2009 were evaluated. Of the participants, 327 had a GFH and 646 had a PH of breast cancer.

  • Overall sensitivity of screening MRI (the percentage of people who tested positive for breast cancer among those who had the disease) was 92.6%.
  • More cancers were detected (cancer yield) and specificity was greater among women with a PH compared with those with a GFH (cancer yield of 3.1% versus 1.5%, respectively, and specificity of 93.6% versus 86.3%, respectively).
  • Biopsy was recommended for fewer participants in the PH group compared with the GFH group (9.3% versus 15.0%, respectively).
  • Biopsy among the PH group had a greater positive predictive value (rate of accurately identifying disease) than among the GFH group (35.7% versus 12.2%, respectively).

These results suggest that screening MRI performs well among women with a personal history of breast cancer, and may be a worthwhile addition to screening mammography for these women. The researchers add that larger studies of MRI screening in this population are warranted.
Reference: Kalish G, DeMartini WB, Peacock S, et al. Screening MRI for high risk zwomen: should patients with a treated personal history of breast cancer be screened? Presented at the Radiological Society of North America (RSNA) 96th Scientific Assembly and Annual Meeting; November 28-December 3, 2010; Chicago, Il. Abstract SSAO1-01.

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