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 Magnetic resonance imaging based 3-dimensional printed breast surgical guide for breast-conserving surgery in ductal carcinoma in situ: a clinical trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhen-Yu Wu ◽  
Aisha Alzuhair ◽  
Heejeong Kim ◽  
Jong Won Lee ◽  
Il Yong Chung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Resonance Imaging ◽  
Surgical Guide

Abstract Breast-conserving surgery (BCS) is performed in patients with ductal carcinoma in situ (DCIS) because of the small size of the tumor. It is essential to know the quantitative extent of the tumor before performing this precise partial resection surgery. A three-dimensional printed (3DP) breast surgical guide (BSG) was developed using information obtained from supine magnetic resonance imaging (MRI) and 3D printing technology and it was used for treating patients with breast cancer. Here, we report our experience with the application of the BSG for patients with DCIS. Patients with breast cancer who underwent BCS from July 2017 to February 2019 were included in this study. The patients underwent partial resection with a supine-MRI based 3DP-BSG. A total of 102 BCS using 3DP-BSG were conducted, and 11 cases were DCIS. The patients’ median age was 56 years (range, 38–69 years). The mean tumor diameter was 1.3 ± 0.9 cm. The median surgical time was 70 min (range, 40–88 min). All patients had tumor-free resection margins. The median distance from the tumor to the margin was 11 mm (range, 2–35 mm). Direct demarcation of the tumor extent in the breast and a pain-free procedure are the advantages of using 3DP-BSG in patients with DCIS. Trial registration: Clinical Research Information Service (CRIS) Identifier Number: KCT0002375, KCT0003043.

Abbreviated Magnetic Resonance Imaging (MRI) for Breast Cancer Screening: Rationale, Concept, and Transfer to Clinical Practice

2019 ◽  
Vol 70 (1) ◽  
pp. 501-519 ◽  
Author(s):  
Christiane K. Kuhl
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Cancer Screening ◽  
Magnetic Resonance ◽  
Breast Cancer Screening ◽  
Breast Cancer Mortality ◽  
Mammographic Screening ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Profile

Given the increasing understanding of cancer as a heterogeneous group of diseases, detection methods should offer a sensitivity profile that ensures perfect sensitivity for biologically important cancers while screening out self-limiting pseudocancers. However, mammographic screening is biased toward detection of ductal carcinoma in situ and slowly growing cancers—and thus frequently fails to detect biologically aggressive cancers. This explains the persistently high rates of interval cancers and high rates of breast cancer mortality observed in spite of decades of mammographic screening. Magnetic resonance imaging (MRI), in contrast, has a sensitivity profile that matches clinical needs. Conventional MRI is not suitable for population-wide screening due to high cost, limited tolerability, and lack of availability. We introduced abbreviated MRI in 2014. Abbreviated MRI will change the way MRI is used in clinical medicine. This article describes the rationale to use MRI in general, and abbreviated MRI in particular, for breast cancer screening.

scholarly journals Preoperative Magnetic Resonance Imaging in Patients With Stage I Invasive Ductal Breast Cancer: A Prospective Randomized Study

2017 ◽  
Vol 107 (1) ◽  
pp. 14-22
Author(s):  
N. Brück ◽  
I. Koskivuo ◽  
P. Boström ◽  
J. Saunavaara ◽  
R. Aaltonen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ductal Carcinoma ◽  
Breast Magnetic Resonance Imaging ◽  
Preoperative Magnetic Resonance Imaging ◽  
Control Group ◽  
Resonance Imaging ◽  
Preoperative Magnetic Resonance ◽  
Breast Magnetic Resonance

Background and Aims: Preoperative magnetic resonance imaging has become an important complementary imaging technique in patients with breast cancer, providing additional information for preoperative local staging. Magnetic resonance imaging is recommended selectively in lobular breast cancer and in patients with dense breast tissue in the case when mammography and ultrasound fail to fully evaluate the lesion, but the routine use of magnetic resonance imaging in all patients with invasive ductal carcinoma is controversial. The purpose of this randomized study was to investigate the diagnostic value of preoperative magnetic resonance imaging and its impact on short-term surgical outcome in newly diagnosed unifocal stage I invasive ductal carcinoma. Material and Methods: A total of 100 patients were randomized to either receive preoperative breast magnetic resonance imaging or to be scheduled directly to operation without magnetic resonance imaging on a 1:1 basis. There were 50 patients in both study arms. Results: In 14 patients (28%), breast magnetic resonance imaging detected an additional finding and seven of them were found to be malignant. Six additional cancer foci were found in the ipsilateral breast and one in the contralateral breast. Magnetic resonance imaging findings caused a change in planned surgical management in 10 patients (20%). Mastectomy was performed in six patients (12%) in the magnetic resonance imaging group and in two patients (4%) in the control group ( p = 0.140). The breast reoperation rate was 14% in the magnetic resonance imaging group and 24% in the control group ( p = 0.202). The mean interval between referral and first surgical procedure was 34 days in the magnetic resonance imaging group and 21 days in the control group ( p < 0.001). Conclusion: Preoperative magnetic resonance imaging may be beneficial for some patients with early-stage invasive ductal carcinoma, but its routine use is not recommended without specific indications.

scholarly journals Triple-Modality Screening Trial for Familial Breast Cancer Underlines the Importance of Magnetic Resonance Imaging and Questions the Role of Mammography and Ultrasound Regardless of Patient Mutation Status, Age, and Breast Density

2015 ◽  
Vol 33 (10) ◽  
pp. 1128-1135 ◽  
Author(s):  
Christopher C. Riedl ◽  
Nikolaus Luft ◽  
Clemens Bernhart ◽  
Michael Weber ◽  
Maria Bernathova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Density ◽  
Familial Breast Cancer ◽  
Ductal Carcinoma ◽  
Added Value ◽  
High Risk Population ◽  
Resonance Imaging ◽  
Mutation Status

Purpose To evaluate the breast cancer screening efficacy of mammography, ultrasound, and magnetic resonance imaging (MRI) in a high-risk population and in various population subgroups. Patients and Methods In a single-center, prospective, nonrandomized comparison study, BRCA mutation carriers and women with a high familial risk (> 20% lifetime risk) for breast cancer were offered screening with mammography, ultrasound, and MRI every 12 months. Diagnostic performance was compared between individual modalities and their combinations. Further comparisons were based on subpopulations dichotomized by screening rounds, mutation status, age, and breast density. Results There were 559 women with 1,365 complete imaging rounds included in this study. The sensitivity of MRI (90.0%) was significantly higher (P < .001) than that of mammography (37.5%) and ultrasound (37.5%). Of 40 cancers, 18 (45.0%) were detected by MRI alone. Two cancers were found by mammography alone (a ductal carcinoma in situ [DCIS] with microinvasion and a DCIS with < 10-mm invasive areas). This did not lead to a significant increase of sensitivity compared with using MRI alone (P = .15). No cancers were detected by ultrasound alone. Similarly, of 14 DCISs, all were detected by MRI, whereas mammography and ultrasound each detected five DCISs (35.7%). Age, mutation status, and breast density had no influence on the sensitivity of MRI and did not affect the superiority of MRI over mammography and ultrasound. Conclusion MRI allows early detection of familial breast cancer regardless of patient age, breast density, or risk status. The added value of mammography is limited, and there is no added value of ultrasound in women undergoing MRI for screening.

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