scholarly journals Subsequent Breast Cancer in Female Childhood Cancer Survivors in the St Jude Lifetime Cohort Study (SJLIFE)

2019 ◽  
Vol 37 (19) ◽  
pp. 1647-1656 ◽  
Author(s):  
Matthew J. Ehrhardt ◽  
Carrie R. Howell ◽  
Karen Hale ◽  
Malek J. Baassiri ◽  
Carol Rodriguez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Childhood Cancer Survivors ◽  
Cancer Predisposition ◽  
Breast Cancers ◽  
Resonance Imaging ◽  
Increased Risk ◽  
Physical Findings ◽  
Cancer Predisposition Gene

PURPOSE Anthracycline-associated risk for subsequent breast cancer in childhood cancer survivors is hypothesized to be mediated by TP53 mutation-related gene-environment interactions. We characterized treatment/genetic risks and the impact of screening for breast cancer in the St Jude Lifetime Cohort. PATIENTS AND METHODS Female participants underwent risk-based assessments, prior health event validation, chest radiation dosimetry, and whole genome sequencing. Breast biopsy reports were reviewed. A subgroup (n = 139) underwent both breast magnetic resonance imaging and mammography. Multivariable regression was used to calculate hazard ratios (HRs) and 95% CIs. RESULTS Among 1,467 women, 56 developed 68 breast cancers at a median age 38.6 (range, 24.5 to 53.0) years. Cumulative incidences at age 35 years were 1% (no chest radiation) and 8% (≥ 10 Gy of chest radiation). In adjusted models, breast cancer was associated with 20 Gy or more of chest radiation versus none (HR, 7.6; 95% CI, 2.9 to 20.4), anthracycline exposure versus none (1 to 249 mg/m2: HR, 2.6; 95% CI, 1.1 to 6.2; ≥ 250 mg/m2: HR, 13.4, 95% CI, 5.5 to 32.5), and having a breast cancer predisposition gene mutation (HR, 23.0; 95% CI, 7.3 to 72.2). Anthracyclines 250 mg/m2 or greater remained significantly associated with increased risk of breast cancer in models excluding survivors with cancer predisposition gene mutations, chest radiation 10 Gy or greater, or both. Sensitivity/specificity were 53.8%/96.3% for mammography, 69.2%/91.4% for magnetic resonance imaging, and 85.8%/99.7% for dual imaging. Breast cancers detected by imaging and/or prophylactic mastectomy compared with physical findings were more likely to be in situ carcinomas, smaller, without lymph node involvement, and treated without chemotherapy. CONCLUSION Higher doses of anthracyclines are associated with increased risk of breast cancer independent of mutations in known cancer predisposition genes. Surveillance imaging identifies breast cancers less likely to require chemotherapy than those detected by physical findings.

Effectiveness of Screening With Annual Magnetic Resonance Imaging and Mammography: Results of the Initial Screen From the Ontario High Risk Breast Screening Program

2014 ◽  
Vol 32 (21) ◽  
pp. 2224-2230 ◽  
Author(s):  
Anna M. Chiarelli ◽  
Maegan V. Prummel ◽  
Derek Muradali ◽  
Vicky Majpruz ◽  
Meaghan Horgan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
High Risk ◽  
Magnetic Resonance ◽  
Gene Mutation ◽  
Breast Screening ◽  
Screening Program ◽  
Resonance Imaging ◽  
Mutation Carriers ◽  
Increased Risk

Purpose The Ontario Breast Screening Program expanded in July 2011 to screen women age 30 to 69 years at high risk for breast cancer with annual magnetic resonance imaging (MRI) and digital mammography. To the best of our knowledge, this is the first organized screening program for women at high risk for breast cancer. Patients and Methods Performance measures after assessment were compared with screening results for 2,207 women with initial screening examinations. The following criteria were used to determine eligibility: known mutation in BRCA1, BRCA2, or other gene predisposing to a markedly increased risk of breast cancer, untested first-degree relative of a gene mutation carrier, family history consistent with hereditary breast cancer syndrome and estimated personal lifetime breast cancer risk ≥ 25%, or radiation therapy to the chest (before age 30 years and at least 8 years previously). Results The recall rate was significantly higher among women who had abnormal MRI alone (15.1%; 95% CI, 13.8% to 16.4%) compared with mammogram alone (6.4%; 95% CI, 5.5% to 7.3%). Of the 35 breast cancers detected (16.3 per 1,000; 95% CI, 11.2 to 22.2), none were detected by mammogram alone, 23 (65.7%) were detected by MRI alone (10.7 per 1,000; 95% CI, 6.7 to 15.8), and 25 (71%) were detected among women who were known gene mutation carriers (30.8 per 1,000, 95% CI, 19.4 to 43.7). The positive predictive value was highest for detection based on mammogram and MRI (12.4%; 95% CI, 7.3% to 19.3%). Conclusion Screening with annual MRI combined with mammography has the potential to be effectively implemented into an organized breast screening program for women at high risk for breast cancer. This could be considered an important management option for known BRCA gene mutation carriers.

scholarly journals Radiological diagnostics of triple negative breast cancer: a review

2011 ◽  
Vol 18 (2) ◽  
pp. 98-106
Author(s):  
Sigutė STADALNYKAITĖ ◽  
Rūta BRIEDIENĖ
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Breast Cancers ◽  
Resonance Imaging ◽  
Radiological Diagnostics ◽  
Characteristic Features

Background. Triple negative breast cancer has a poor prognosis. Therefore, it is vital to detect this subtype of breast cancer in its early stage. The imaging features of this clinically important subtype of breast cancer are not well known. There have been no published reports about radiological diagnostics of triple negative breast tumour in Lithuania. The purpose of this study was to review the imaging characteristics of triple receptor negative cancers in mammography, ultrasonography and magnetic resonance imaging (MRI). Materials and methods. The published data for the period 2006–2011 concerning the imaging of triple negative breast cancer were analyzed. There were ten retrospective, ten prospective studies and five reviews. Five studies were on mammography imaging, three on both mammography and ultrasonography imaging, and five studies dealt with MR imaging data. Two studies analysed all three diagnostic methods. Results. In mammography, triple negative breast (TRN) cancers often present as a mass and are most frequently round, oval or lobular in shape, less frequently being irregular. TRN tumours aren’t associated with calcifications. Moreover, architectural distortion is not a characteristic feature of triple negative breast cancer. In ultrasonography, TRN cancer appears as a parallel. TRN breast tumours mostly are irregular in shape and have a circumscribed margin. Attenuating posterior echoes and hypervascularity are not their characteristic features. In MR imaging, TRN breast cancer tends to have a lobulated, round or oval mass shape. Rim enhancement is identified in most of TRN tumours. Initially, rapid enhancement with a washout pattern (a sign of malignancy) does not usually apply to triple-negative breast cancers. Conclusions. TRN breast cancer is difficult to diagnose, because usually it has no specific imaging signs typical of breast cancer. In mammography, TRN cancers aren’t associated with microcalcifications. In ultrasonography, attenuating posterior echoes and hypervascularity are not characteristic features of TRN tumours. In MRI, initially rapid enhancement with a washout pattern does not usually apply to triple-negative breast cancers. Keywords: triple negative breast cancer, mammography, ultrasonography, magnetic resonance imaging

Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast Cancer

2005 ◽  
Vol 23 (33) ◽  
pp. 8469-8476 ◽  
Author(s):  
Christiane K. Kuhl ◽  
Simone Schrading ◽  
Claudia C. Leutner ◽  
Nuschin Morakkabati-Spitz ◽  
Eva Wardelmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Familial Risk ◽  
Interval Cancer ◽  
Breast Ultrasound ◽  
Breast Cancer Susceptibility Gene ◽  
Breast Cancers ◽  
Resonance Imaging ◽  
Higher Sensitivity

Purpose To compare the effectiveness of mammography, breast ultrasound, and magnetic resonance imaging (MRI) for surveillance of women at increased familial risk for breast cancer (lifetime risk of 20% or more). Patients and Methods We conducted a surveillance cohort study of 529 asymptomatic women who, based on their family history and/or mutational analysis, were suspected or proven to carry a breast cancer susceptibility gene (BRCA). A total of 1,542 annual surveillance rounds were completed with a mean follow-up of 5.3 years. Diagnostic accuracies of the three imaging modalities used alone or in different combinations were compared. Results Forty-three breast cancers were identified in the total cohort (34 invasive, nine ductal carcinoma-in-situ). Overall sensitivity of diagnostic imaging was 93% (40 of 43 breast cancers); overall node-positive rate was 16%, and one interval cancer occurred (one of 43 cancers, or 2%). In the analysis by modality, sensitivity was low for mammography (33%) and ultrasound (40%) or the combination of both (49%). MRI offered a significantly higher sensitivity (91%). The sensitivity of mammography in the higher risk groups was 25%, compared with 100% for MRI. Specificity of MRI (97.2%) was equivalent to that of mammography (96.8%). Conclusion Mammography alone, and also mammography combined with breast ultrasound, seems insufficient for early diagnosis of breast cancer in women who are at increased familial risk with or without documented BRCA mutation. If MRI is used for surveillance, diagnosis of intraductal and invasive familial or hereditary cancer is achieved with a significantly higher sensitivity and at a more favorable stage.

Breast Cancer Tumor Size Assessment with Mammography, Ultrasonography, and Magnetic Resonance Imaging at a Community Based Multidisciplinary Breast Center

2012 ◽  
Vol 78 (4) ◽  
pp. 440-446 ◽  
Author(s):  
Sarah Ines Ramirez ◽  
Max Scholle ◽  
Jennifer Buckmaster ◽  
Robert Hunter Paley ◽  
Gopal Chandru Kowdley
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tumor Size ◽  
Preoperative Imaging ◽  
Breast Cancers ◽  
Resonance Imaging ◽  
Community Based ◽  
Breast Center ◽  
Cancer Tumor

Paramount to staging and patient management is accurately measuring the size of invasive breast cancers. We assessed the accuracy of mammography (MG), ultrasonography (US), and magnetic resonance imaging (MRI) at our community-based hospital in which multiple radiologists and imaging machines are used in the care of our patients. We performed a retrospective analysis of a prospectively maintained database of 277 patients seen at our breast center from 2009 to 2010. We tabulated MG, US, and MRI-reported tumor sizes in 161 women with pathology-proven invasive breast cancer and compared the preoperative size measurements with final pathologic tumor size. In the 161 patients, 169 lesions were identified. Imaging using all three modalities was available in 47 patients. When compared with final pathology, MRI had a correlation of r = 0.75 to mean tumor size as compared with US (r = 0.67) and MG (r = 0.76). Mean tumor size was 1.90 cm by MG, 1.87 cm by US, 2.40 cm by MRI, and 2.19 cm by pathology. We were able to achieve an excellent correlation of pathologic tumor size to preoperative imaging. The absolute differences in size between the modalities were small. MRI, in select patients, added to the assessment of tumor size based on US and MG.

scholarly journals Prospective Study of Breast Cancer Incidence in Women With a BRCA1 or BRCA2 Mutation Under Surveillance With and Without Magnetic Resonance Imaging

2011 ◽  
Vol 29 (13) ◽  
pp. 1664-1669 ◽  
Author(s):  
Ellen Warner ◽  
Kimberley Hill ◽  
Petrina Causer ◽  
Donald Plewes ◽  
Roberta Jong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cumulative Incidence ◽  
Comparison Group ◽  
Brca2 Mutation ◽  
Breast Cancer Incidence ◽  
Advanced Stage ◽  
Breast Cancers ◽  
Resonance Imaging

Purpose The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening. Patients and Methods We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years. In total, 445 women were enrolled in an MRI screening trial in Toronto, Ontario, Canada, and 830 were in the comparison group. The cumulative incidences of ductal carcinoma in situ (DCIS), early-stage, and late-stage breast cancers were estimated at 6 years in the cohorts. Results There were 41 cases of breast cancer in the MRI-screened cohort (9.2%) and 76 cases in the comparison group (9.2%). The cumulative incidence of DCIS or stage I breast cancer at 6 years was 13.8% (95% CI, 9.1% to 18.5%) in the MRI-screened cohort and 7.2% (95% CI, 4.5% to 9.9%) in the comparison group (P = .01). The cumulative incidence of stages II to IV breast cancers was 1.9% (95% CI, 0.2% to 3.7%) in the MRI-screened cohort and 6.6% (95% CI, 3.8% to 9.3%) in the comparison group (P = .02). The adjusted hazard ratio for the development of stages II to IV breast cancer associated with MRI screening was 0.30 (95% CI, 0.12 to 0.72; P = .008). Conclusion Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced-stage breast cancer in BRCA1 and BRCA2 carriers.

Magnetic Resonance Imaging Features in Triple-Negative Breast Cancer: Comparison With Luminal and HER2-Overexpressing Tumors

2012 ◽  
Vol 12 (5) ◽  
pp. 331-339 ◽  
Author(s):  
Melania Costantini ◽  
Paolo Belli ◽  
Daniela Distefano ◽  
Enida Bufi ◽  
Marialuisa Di Matteo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Imaging Features ◽  
Resonance Imaging

scholarly journals Breast cancer and background parenchymal enhancement at breast magnetic resonance imaging: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Hu ◽  
Jinghao Zhao ◽  
Yong Li ◽  
Quanshui Fu ◽  
Linwei Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Magnetic Resonance Imaging ◽  
Meta Analysis ◽  
Resonance Imaging ◽  
High Background ◽  
Background Parenchymal Enhancement ◽  
Breast Magnetic Resonance ◽  
Parenchymal Enhancement

Abstract Background The background parenchymal enhancement at breast magnetic resonance imaging use to predict breast cancer attracts many searchers to draw a possible relationship. However, the results of their relationships were conflicting. This meta-analysis was performed to assess breast cancer frequency associations with background parenchymal enhancement. Methods A systematic literature search up to January 2020 was performed to detect studies recording associations between breast cancer frequency and background parenchymal enhancement. We found thirteen studies including 13,788 women at the start with 4046 breast cancer. We calculated the odds ratio (OR) and the 95% confidence intervals (CIs) between breast cancer frequency and background parenchymal enhancement by the dichotomous technique with a random or fixed-effect model. Results Women with minimal or mild background parenchymal enhancement at breast magnetic resonance imaging did not have any risk of breast cancer compared to control women (OR, 1.20; 95% CI 0.54–2.67). However, high background parenchymal enhancement at breast magnetic resonance imaging (OR, 2.66; 95% CI 1.36–5.19) and moderate (OR, 2.51; 95% CI 1.49–4.21) was associated with a significantly higher rate of breast cancer frequency compared to control women. Conclusions Our meta-analysis showed that the women with high and moderate background parenchymal enhancement at breast magnetic resonance imaging have higher risks, up to 2.66 fold, of breast cancer. We suggest that women with high or moderate background parenchymal enhancement at breast magnetic resonance imaging to be scheduled for more frequent follow-up and screening for breast cancer to avoid any complications.

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