Screening breast MR imaging in women with a history of lobular carcinoma in situ Journal Article


Authors: Sung, J. S.; Malak, S. F.; Bajaj, P.; Alis, R.; Dershaw, D. D.; Morris, E. A.
Article Title: Screening breast MR imaging in women with a history of lobular carcinoma in situ
Abstract: Purpose: To assess the utility of screening magnetic resonance (MR) imaging in the detection of otherwise occult breast cancers in women with a history of lobular carcinoma in situ (LCIS). Materials and Methods: This HIPAA-compliant study received institutional review board approval. The need for informed consent was waived. Retrospective review of the database yielded 670 screening breast MR studies obtained between January 2003 and September 2008 in 220 women with a history of LCIS. MR and mammographic findings were reviewed. Number of cancers diagnosed, method of detection, and tumor characteristics were examined. The cumulative incidence of developing breast cancer as detected with MR imaging and mammography was calculated. Breast density was examined as a prognostic factor in the cumulative incidence analysis. Results: Biopsy was recommended in 63 lesions seen in 58 (9%) of 670 screening MR studies. Eight additional lesions were identified at short-term follow-up MR imaging for a total of 71 lesions in 59 patients. Twelve cancers (20%) were identified in 60 lesions sampled. Biopsy was recommended in 26 additional lesions identified at mammography; biopsy was performed in 25 of these lesions and revealed malignancy in five (20%). Overall, 17 cancers were detected in 14 patients during the study period. Of these, 12 were detected with MR imaging alone, and five were detected with mammography alone. Of the 12 cancers detected at MR imaging, there were nine invasive cancers and three cases of ductal carcinoma in situ (DCIS). Of the five cancers detected at mammography, two were invasive and three were DCIS. Conclusion: MR imaging is a useful adjunct modality with which to screen women with a history of LCIS at high-risk of developing breast cancer, resulting in a 4.5% incremental cancer detection rate. Sensitivity in the detection of breast cancers with a combination of MR imaging and mammography was higher than sensitivity of either modality alone. © RSNA, 2011.
Keywords: adult; controlled study; aged; middle aged; retrospective studies; major clinical study; anamnesis; nuclear magnetic resonance imaging; follow up; magnetic resonance imaging; cancer diagnosis; sensitivity and specificity; sensitivity analysis; disease association; breast cancer; incidence; risk factors; cancer screening; mass screening; breast neoplasms; retrospective study; biopsy; mammography; carcinoma in situ; chi-square distribution; contrast media; invasive carcinoma; gadolinium dtpa; intraductal carcinoma; roc curve; breast biopsy; lobular carcinoma in situ; carcinoma, lobular
Journal Title: Radiology
Volume: 261
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2011-11-01
Start Page: 414
End Page: 420
Language: English
DOI: 10.1148/radiol.11110091
PROVIDER: scopus
PUBMED: 21900617
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Janice Sinae Sung
    33 Sung
  2. D David Dershaw
    176 Dershaw
  3. Elizabeth A Morris
    247 Morris
  4. Sharp Malak
    13 Malak
  5. Rebecca E Alis
    1 Alis