MRI of occult breast carcinoma in a high-risk population Journal Article

Authors: Morris, E. A.; Liberman, L.; Ballon, D. J.; Robson, M.; Abramson, A. F.; Heerdt, A.; Dershaw, D. D.
Article Title: MRI of occult breast carcinoma in a high-risk population
Abstract: OBJECTIVE. The purpose of this study was to determine the frequency of cancer and the positive predictive value of biopsy in the first screening round of breast MRI in women at high risk of developing breast cancer. MATERIALS AND METHODS. Retrospective review was performed of the records of 367 consecutive women at high risk of developing breast cancer who had normal findings on mammography and their first breast MRI screening examination during a 2-year period. The frequency of recommending biopsy at the first screening MRI study and the biopsy results were reviewed. RESULTS. Biopsy was recommended in 64 women (17%). Biopsy revealed cancer that was occult on mammography and physical examination in 14 (24%) of 59 women who had biopsy and in 14 (4%) of 367 women who underwent breast MRI screening. Histologic findings in 14 women with cancer were ductal carcinoma in situ in eight (57%) and infiltrating carcinoma in six (43%). The median size of infiltrating carcinoma was 0.4 cm (range, 0.1-1.2 cm). Two patients had nodes that were positive for cancer. Biopsy revealed high-risk lesions (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, or radial scar) in 13 (4%) of 367 women and other benign findings in 32 (9%) of 367 women who had MRI screening. CONCLUSION. Among women at high risk of developing breast cancer, breast MRI led to a recommendation of biopsy in 17%. Cancer was found in 24% of women who underwent biopsy and in 4% of women who had breast MRI screening. More than half the MRI-detected cancers were ductal carcinoma in situ.
Keywords: adult; human tissue; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; histopathology; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer screening; breast neoplasms; prediction; biopsy; time factors; risk assessment; mammography; breast carcinoma; carcinoma in situ; cancer size; predictive value of tests; physical examination; high risk population; radiodiagnosis; carcinoma, intraductal, noninfiltrating; breast biopsy; carcinoma, ductal, breast; breast hyperplasia; occult cancer; humans; human; female; priority journal; article
Journal Title: American Journal of Roentgenology
Volume: 181
Issue: 3
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2003-09-01
Start Page: 619
End Page: 626
Language: English
PUBMED: 12933450
PROVIDER: scopus
Notes: Export Date: 12 September 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. D David Dershaw
    223 Dershaw
  2. Laura Liberman
    173 Liberman
  3. Mark E Robson
    599 Robson
  4. Elizabeth A Morris
    332 Morris
  5. Alexandra S Heerdt
    106 Heerdt
  6. Douglas J Ballon
    49 Ballon