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.

scholarly journals Breast Cancer Mortality among Women with a BRCA1 or BRCA2 Mutation in a Magnetic Resonance Imaging Plus Mammography Screening Program

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3479
Author(s):  
Ellen Warner ◽  
Siqi Zhu ◽  
Donald B. Plewes ◽  
Kimberley Hill ◽  
Elizabeth A. Ramsay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cancer Mortality ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Brca2 Mutation ◽  
Breast Cancer Mortality ◽  
Standardized Mortality Ratio ◽  
Resonance Imaging

Annual breast magnetic resonance imaging (MRI) plus mammography is the standard of care for screening women with inherited BRCA1/2 mutations. However, long-term breast cancer-related mortality with screening is unknown. Between 1997 and June 2011, 489 previously unaffected BRCA1/2 mutation carriers aged 25 to 65 years were screened with annual MRI plus mammography on our study. Thereafter, participants were eligible to continue MRI screening through the high-risk Ontario Breast Screening Program. In 2019, our data were linked to the Ontario Cancer Registry of Cancer Care Ontario to identify all incident cancers, vital status and causes of death. Observed breast cancer mortality was compared to expected mortality for age-matched women in the general population. There were 91 women diagnosed with breast cancer (72 invasive and 19 ductal carcinoma in situ (DCIS)) with median follow-up 7.4 (range: 0.1 to 19.2) years. Four deaths from breast cancer were observed, compared to 2.0 deaths expected (standardized mortality ratio (SMR) 2.0, p = 0.14). For the 489 women in the study, the probability of not dying of breast cancer at 20 years from the date of the first MRI was 98.2%. Annual screening with MRI plus mammography is a reasonable option for women who decline or defer risk-reducing mastectomy.

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

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.

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.

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
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