Breast cancers detected at screening MR imaging and mammography in patients at high risk: Method of detection reflects tumor histopathologic results Journal Article


Authors: Sung, J. S.; Stamler, S.; Brooks, J.; Kaplan, J.; Huang, T.; Dershaw, D. D.; Lee, C. H.; Morris, E. A.; Comstock, C. E.
Article Title: Breast cancers detected at screening MR imaging and mammography in patients at high risk: Method of detection reflects tumor histopathologic results
Abstract: Purpose: To compare the clinical, imaging, and histopathologic features of breast cancers detected at screening magnetic resonance (MR) imaging, screening mammography, and those detected between screening examinations (interval cancers) in women at high risk. Materials and Methods: This retrospective institutional review board-approved, HIPAA-compliant review of 7519 women at high risk for breast cancer who underwent screening with MR imaging and mammography between January 2005 and December 2010 was performed to determine the number of screeningdetected and interval cancers diagnosed. The need for informed consent was waived. Medical records were reviewed for age, risk factors (family or personal history of breast cancer, BRCA mutation status, history of high-risk lesion or mantle radiation), tumor histopathologic results, and time between diagnosis of interval cancer and most recent screening examination. The x2 test and logistic regression methods were used to compare the features of screening MR imaging, screening mammography, and interval cancers. The Wilcoxon signed-rank test was used to calculate P values. Results: A total of 18 064 screening MR imaging examinations and 26 866 screening mammographic examinations were performed. Two hundred twenty-two cancers were diagnosed in 219 women, 167 (75%) at MR imaging, 43 (19%) at mammography, and 12 (5%) interval cancers. Median age at diagnosis was 52 years. No risk factors were associated with screening MR imaging, screening mammography, or interval cancer (P . .06). Cancers found at screening MR imaging were more likely to be invasive cancer (118 of 167 [71%]; P , .0001). Of the 43 cancers found at screening mammography, 38 (88%) manifested as calcifications and 28 (65%) were ductal carcinoma in situ. Interval cancers were associated with nodal involvement (P = .005) and the triple-negative subtype (P = .03). Conclusion: In women at high risk for breast cancer who underwent screening with mammography and MR imaging, invasive cancers were more likely to be detected at MR imaging, whereas most cancers detected at screening mammography were ductal carcinoma in situ. Interval cancers were found infrequently and were more likely to be node positive and of the triple-negative subtype. © RSNA, 2016.
Journal Title: Radiology
Volume: 280
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2016-09-01
Start Page: 716
End Page: 722
Language: English
DOI: 10.1148/radiol.2016151419
PROVIDER: scopus
PMCID: PMC5006733
PUBMED: 27097237
DOI/URL:
Notes: Article -- Export Date: 3 October 2016 -- Source: Scopus
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MSK Authors
  1. Jennifer Kaplan
    25 Kaplan
  2. Janice Sinae Sung
    40 Sung
  3. Carol Lee
    22 Lee
  4. D David Dershaw
    203 Dershaw
  5. Elizabeth A Morris
    287 Morris
  6. Tammy Huang
    1 Huang