Younger women (50 years and under) who have undergone breast conservation therapy (BCT) may benefit from an MRI in addition to annual mammogram screenings, according to a study published in JAMA Oncology.1
Patients who have undergone BCT are at increased risk for recurrence, and early detection of second breast cancers improves the relative survival of patients. Study authors wanted to confirm that a combination of imaging techniques would lead to better detection than mammography alone.
The multicenter, prospective, nonrandomized study (ClinicalTrials.gov Identifier: NCT01257152) enrolled 754 women age 50 and younger at initial diagnosis who had undergone BCT. Patients had MRI, ultrasonography, and mammography screenings of the conserved and contralateral breasts annually over 3 years.
A total of 2065 mammograms, ultrasonography, and MRI screenings were performed on study patients. Seventeen cancers were detected, and 76% of diagnosed cancers were early stage (0 or 1).
MRI with mammography had an overall higher sensitivity (100% vs 53%; P = .01) and detection rate (8.2 vs 4.4 per 1000; P = .003) than mammography alone. Cancer detection rates in ultrasonography in addition to mammography (6.8 vs 4.4 per 1000; P = .03) were higher than that by mammography alone.
The specificity of mammography with MRI or ultrasonography (87% or 88% vs 96%; P < .001) was lower than that of mammography alone.
The results of the study indicate that MRI imaging in addition to mammogram screening improves the detection rate of early-stage breast cancers at acceptable specificity.
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The authors concluded by adding that the results can also help to develop personalized screening guidelines for patients who are at increased risk of breast cancer.
- Cho N, Han W, Han BK, et al. 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. JAMA Oncol. 2017 Jun 22. doi:10.1001/jamaoncol.2017.1256 [Epub ahead of print]