Study finds breast magnetic resonance imaging is most effective, detects earlier-stage cancer-- A. Agrawal, PhD
Tuesday, March 2, 2010 (Last Updated: 03/03/2010)
TUESDAY, March 2 (HealthDay News) -- Breast cancers are most likely to be detected during annual screening by breast magnetic resonance imaging (MRI) compared with ultrasound or mammography in women at high familial risk, and the cancers detected are more likely to be at earlier stages, according to a study published online Feb. 22 in the Journal of Clinical Oncology.
Christiane Kuhl, M.D., of the University of Bonn in Germany, and colleagues prospectively investigated the cancer yield and diagnostic accuracy of annual clinical breast examination, mammography, quality-assured breast MRI, and ultrasound -- used alone or in various combinations -- to screen for breast cancer in 687 asymptomatic women at elevated familial risk who underwent 1,679 annual screening rounds.
After a median follow-up of 29.09 months, the researchers found that 27 women were diagnosed with breast cancer, with 41 percent ductal carcinoma in situ, 59 percent invasive cancers, and 11 percent node positive. Breast MRI was most effective in detecting cancer (14.9 per 1,000) and the detection rate was not significantly improved by adding mammography or ultrasound. The positive predictive value was 48 percent for breast MRI compared with 39 percent for mammography and 36 percent for ultrasound. All cancers were detected during annual screening, and no additional cancers were detected in a subgroup of 371 women who underwent additional half-yearly ultrasound and clinical breast exam.
"In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage," Kuhl and colleagues conclude. "In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or clinical breast examination will add to the cancer yield achieved by MRI alone."
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