Log in

Results of Magnetic Resonance Imaging (MRI) Screening in Patients at High Risk for Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Screening MRI as an adjunct to mammography is recommended by the ACS for patients with a lifetime risk for breast cancer > 20%. While the benefits are clear, MRI screening is associated with an increase in false-positive results. The purpose of this study was to analyze our institutional database of high-risk patients and assess the uptake of screening MRI examinations and the results of those screenings.

Methods

Our institutional review board-approved High-Risk Breast Cancer Database was queried for patients enrolled from January 2017 to January 2023 who were at high risk for breast cancer in a comparative analysis between those who were screened versus not screened with MRIs. Variables of interest included risk factor, background, MRI screening uptake, and frequency and results of image-guided breast biopsies.

Results

A total of 254 of 1106 high-risk patients (23%) had MRI screening. Forty-six of 852 (5.3%) patients in the non-MRI-screened cohort and nine of 254 (3.5%) patients in the MRI-screened cohort were diagnosed with a malignant lesion after image-guided biopsy (p = 0.6). There was no significant difference between MRI and non-MRI guided biopsies in detecting breast cancer. All malignant lesions were T1 or in situ disease. The 254 patients in the MRI-screened group underwent 185 biopsies. Fifty-seven percent of MRI-guided biopsies yielded benign results.

Conclusions

Although the addition of MRI screening in our high-risk cohort did not produce a significant number of additional cancer diagnoses, patients monitored in our high-risk cohort who developed breast cancer were diagnosed at very early stages of disease, underscoring the benefit of participation in the program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492. Epub 2018 Sep 12. Erratum in: CA Cancer J Clin. 2020;70(4):313

  2. Niell BL, Freer PE, Weinfurtner RJ, Arleo EK, Drukteinis JS. Screening for breast cancer. Radiol Clin North Am. 2017;55(6):1145–62. https://doi.org/10.1016/j.rcl.2017.06.004.

    Article  PubMed  Google Scholar 

  3. Vianna FSL, Giacomazzi J, Oliveira Netto CB, Nunes LN, Caleffi M, Ashton-Prolla P, Camey SA. Performance of the Gail and Tyrer-Cuzick breast cancer risk assessment models in women screened in a primary care setting with the FHS-7 questionnaire. Genet Mol Biol. 2019;42(1 suppl 1):232–7. https://doi.org/10.1590/1678-4685-GMB-2018-0110.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Baretta Z, Mocellin S, Goldin E, Olopade OI, Huo D. Effect of BRCA germline mutations on breast cancer prognosis: a systematic review and meta-analysis. Medicine (Baltimore). 2016;95(40):e4975. https://doi.org/10.1097/MD.0000000000004975.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, Böhm-Vélez M, Mahoney MC, Evans WP 3rd, Larsen LH, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012;307(13):1394–404. https://doi.org/10.1001/jama.2012.388.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Comstock CE, Gatsonis C, Newstead GM, Snyder BS, Gareen IF, Bergin JT, Rahbar H, Sung JS, Jacobs C, Harvey JA, Nicholson MH, Ward RC, Holt J, Prather A, Miller KD, Schnall MD, Kuhl CK. Comparison of abbreviated breast MRI vs digital breast tomosynthesis for breast cancer detection among women with dense breasts undergoing screening. JAMA. 2020;323(8):746–56. https://doi.org/10.1001/jama.2020.0572. Erratum in: JAMA. 2020;323(12):1194.

  7. Mann RM, Cho N, Moy L. Breast MRI: state of the art. Radiology. 2019;292(3):520–36. https://doi.org/10.1148/radiol.2019182947.

    Article  PubMed  Google Scholar 

  8. Heller SL, Moy L. MRI breast screening revisited. J Magn Reson Imaging. 2019;49(5):1212–21. https://doi.org/10.1002/jmri.26547.

    Article  PubMed  Google Scholar 

  9. R Core Team (2022) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.

  10. Yoshida K, Bartel A. Tableone: Create ‘Table 1’ to Describe Baseline Characteristics with or without Propensity Score Weights. R package version 0.13.2, 2022. https://CRAN.R-project.org/package=tableone

  11. Aragon TJ. epitools: Epidemiology Tools. R package version 0.5–10.1. 2022. https://CRAN.R-project.org/package=epitools.

  12. Son D, Phillips J, Mehta TS, Mehta R, Brook A, Dialani VM. Patient preferences regarding use of contrast-enhanced imaging for breast cancer screening. Acad Radiol. 2022;29(Suppl 1):S229–38. https://doi.org/10.1016/j.acra.2021.03.003.

    Article  PubMed  Google Scholar 

  13. Lilly AJ, Johnson M, Kuzmiak CM, Ollila DW, O’Connor SM, Hertel JD, Calhoun BC. MRI-guided core needle biopsy of the breast: radiology-pathology correlation and impact on clinical management. Ann Diagn Pathol. 2020;48:151563. https://doi.org/10.1016/j.anndiagpath.2020.151563.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lehman CD, Isaacs C, Schnall MD, Pisano ED, Ascher SM, Weatherall PT, Bluemke DA, Bowen DJ, Marcom PK, Armstrong DK, Domchek SM, Tomlinson G, Skates SJ, Gatsonis C. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology. 2007;244(2):381–8. https://doi.org/10.1148/radiol.2442060461.

    Article  PubMed  Google Scholar 

  15. Houssami N, Turner RM, Morrow M. Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer. Breast Cancer Res Treat. 2017;165(2):273–83. https://doi.org/10.1007/s10549-017-4324-3.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Deng SX, Castelo M, Reel E, Naganathan G, Eisen A, Muradali D, Grunfeld E, Scheer AS. High-risk breast cancer screening is a double edged sword: a qualitative study of patient perspectives on the Ontario High-Risk Breast Cancer Screening Program. Clin Breast Cancer. 2022;22(8):812–22. https://doi.org/10.1016/j.clbc.2022.08.004.

    Article  PubMed  Google Scholar 

  17. Castelo M, Brown Z, D’Abbondanza JA, Wasilewski NV, Eisen A, Muradali D, Hansen BE, Grunfeld E, Scheer AS. Psychological consequences of MRI-based screening among women with strong family histories of breast cancer. Breast Cancer Res Treat. 2021;189(2):497–508. https://doi.org/10.1007/s10549-021-06300-w.

    Article  PubMed  Google Scholar 

  18. Geuzinge HA, Heijnsdijk EAM, Obdeijn IM, de Koning HJ, Tilanus-Linthorst MMA; FaMRIsc study group. Experiences, expectations and preferences regarding MRI and mammography as breast cancer screening tools in women at familial risk. Breast. 2021;56:1–6. https://doi.org/10.1016/j.breast.2021.01.002.

  19. Bäuerle T, Saake M, Uder M. Gadolinium-based contrast agents: What we learned from acute adverse events, nephrogenic systemic fibrosis and brain retention. Rofo. 2021;193(9):1010–8. https://doi.org/10.1055/a-1328-3177.

    Article  PubMed  Google Scholar 

  20. Pleasant V. Management of breast complaints and high-risk lesions. Best Pract Res Clin Obstet Gynaecol. 2022;83:46–59. https://doi.org/10.1016/j.bpobgyn.2022.03.017.

    Article  PubMed  Google Scholar 

  21. Schiaffino S, Calabrese M, Melani EF, Trimboli RM, Cozzi A, Carbonaro LA, Di Leo G, Sardanelli F. Upgrade rate of percutaneously diagnosed pure atypical ductal hyperplasia: systematic review and meta-analysis of 6458 lesions. Radiology. 2020;294(1):76–86. https://doi.org/10.1148/radiol.2019190748.

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Freya Schnabel MD.

Ethics declarations

Disclosure

None disclosed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miah, P.A., Pourkey, N., Marmer, A. et al. Results of Magnetic Resonance Imaging (MRI) Screening in Patients at High Risk for Breast Cancer. Ann Surg Oncol 30, 6275–6280 (2023). https://doi.org/10.1245/s10434-023-14052-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-023-14052-8

Navigation