14 DAY TRIAL // Mammography is a good way of detecting breast cancer but for women who have a personal history of the disease, it would be very wise to go to an annual MRI screening too, concluded a new study.
Wendy B. DeMartini, MD, assistant professor in the Department of Radiology at the University of Washington Medical Center and Seattle Cancer Care Alliance in Seattle, and colleagues, carried out a study based on the initial breast MRI screenings of 1,026 women, from January 2004 to June 2009.
Dr DeMartini said that “in our study using breast MRI screening, we actually detected proportionally more cancers in women with a personal history of breast cancer, compared with those women with a genetic mutation or strong family history who are currently recommended to have breast MRI.
“Further, women with a personal history were less likely to be recalled for additional testing and less likely to have a biopsy for a false positive MRI finding.”
Among the 1,026 women, 646 had a personal history of treated breast cancer while 327 had a genetic or family history of breast cancer and, on average, MRI scans confirmed 25 of 27 cancers in the group with a personal history, for a sensitivity rate of 92.6%.
Women with a personal history of breast cancer had a cancer yield twice as high as high as those with a genetic or family history – 3.1% compared to 1.5%.
The accuracy of the exam in correctly eliminating the risk of cancer in unaffected areas – which results in lower recall and biopsy rates due to false-positive findings, in the case of women with a personal history was of 93.6%, while for women with a genetic or family history, the specificity was of 86.3%.
In 9.3% of women with a personal history of breast cancer, biopsy was recommended, compared to 15% in women with a genetic and family history of the disease.
Also, the personal history group had a higher rate of cancer prediction (35.7%) than the genetic and family history group (12.2%).
Dr. DeMartini said that the “findings show that the diagnostic performance of MRI in patients with a personal history of treated breast cancer supports consideration of screening MRI as an adjunct to mammography.
“Additional studies such as ours are necessary to establish guidelines for screening this important group of women.”
The American Cancer Society (ACS) currently recommends breast MRI scans in women with a strong family history of breast cancer (more than 20%), or with a known gene mutation.
As for the MRI screening in women who have already had breast cancer, the ACS guidelines admit that there is simply not enough evidence that would recommend or forbid it.
This new study was presented at the annual meeting of the Radiological Society of North America (RSNA).