title: The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk.
abstract: This report presents the preliminary results of the first phase (21 months) of a multi-centre, non-randomised, prospective study, aimed at evaluating the effectiveness of contrast-enhanced magnetic resonance imaging (MRI), X-ray mammography (XM) and ultrasound (US) in early diagnosis of breast cancer (BC) in subjects at high genetic risk. This Italian national trial (coordinated by the Istituto Superiore di Sanità, Rome) so far recruited 105 women (mean age 46.0 years; median age 51.0; age range 25-77 years), who were either proven BRCA1 or BRCA2 mutation carriers or had a 1 in 2 probability of being carriers (40/105 with a previous personal history of BC). Eight cases of breast carcinomas were detected in the trial (mean age 55.3 years, median age 52.5; age range 35-70 years; five with previous personal history of BC). All trial-detected BC cases (8/8) were identified by MRI, while XM and US correctly classified only one. MRI had one false positive case, XM and US none. Seven "MRI-only" detected cancers (4 invasive, 3 in situ) occurred in both pre- (n = 2) and post-menopausal (n = 5) women. With respect to the current XM screening programmes addressed to women in the age range 50-69 years, the global incidence of BC in the trial (7.6%) was over ten-fold higher. The cost per "MRI-only" detected cancer in this particular category of subjects at high genetic risk was substantially lower than that of an XM-detected cancer in the general women population. These preliminary results confirmed that MRI is a very useful tool to screen subjects at high genetic risk for breast carcinoma, not only in pre-, but also in post-menopausal age, with a low probability of false positive cases.
authors.affiliation: Istituto Superiore di Sanità, Laboratorio di Biologia Cellulare, Roma, Italy. fpodo@iss.it
authors.forename: F
authors.initials: F
authors.lastname: Podo
authors.forename: F
authors.initials: F
authors.lastname: Sardanelli
authors.forename: R
authors.initials: R
authors.lastname: Canese
authors.forename: G
authors.initials: G
authors.lastname: D'Agnolo
authors.forename: P G
authors.initials: PG
authors.lastname: Natali
authors.forename: M
authors.initials: M
authors.lastname: Crecco
authors.forename: M L
authors.initials: ML
authors.lastname: Grandinetti
authors.forename: R
authors.initials: R
authors.lastname: Musumeci
authors.forename: G
authors.initials: G
authors.lastname: Trecate
authors.forename: S
authors.initials: S
authors.lastname: Bergonzi
authors.forename: T
authors.initials: T
authors.lastname: De Simone
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: B
authors.initials: B
authors.lastname: Pasini
authors.forename: S
authors.initials: S
authors.lastname: Manuokian
authors.forename: G B
authors.initials: GB
authors.lastname: Spatti
authors.forename: D
authors.initials: D
authors.lastname: Vergnaghi
authors.forename: S
authors.initials: S
authors.lastname: Morassut
authors.forename: M
authors.initials: M
authors.lastname: Boiocchi
authors.forename: R
authors.initials: R
authors.lastname: Dolcetti
authors.forename: A
authors.initials: A
authors.lastname: Viel
authors.forename: C
authors.initials: C
authors.lastname: De Giacomi
authors.forename: A
authors.initials: A
authors.lastname: Veronesi
authors.forename: F
authors.initials: F
authors.lastname: Coran
authors.forename: V
authors.initials: V
authors.lastname: Silingardi
authors.forename: D
authors.initials: D
authors.lastname: Turchett
authors.forename: L
authors.initials: L
authors.lastname: Cortesi
authors.forename: M
authors.initials: M
authors.lastname: De Santis
authors.forename: M
authors.initials: M
authors.lastname: Federico
authors.forename: R
authors.initials: R
authors.lastname: Romagnoli
authors.forename: S
authors.initials: S
authors.lastname: Ferrari
authors.forename: G
authors.initials: G
authors.lastname: Bevilacqua
authors.forename: C
authors.initials: C
authors.lastname: Bartolozzi
authors.forename: M A
authors.initials: MA
authors.lastname: Caligo
authors.forename: A
authors.initials: A
authors.lastname: Cilotti
authors.forename: C
authors.initials: C
authors.lastname: Marini
authors.forename: S
authors.initials: S
authors.lastname: Cirillo
authors.forename: V
authors.initials: V
authors.lastname: Marra
authors.forename: L
authors.initials: L
authors.lastname: Martincich
authors.forename: A
authors.initials: A
authors.lastname: Contegiacomo
authors.forename: M
authors.initials: M
authors.lastname: Pensabene
authors.forename: I
authors.initials: I
authors.lastname: Capuano
authors.forename: G B
authors.initials: GB
authors.lastname: Burgazzi
authors.forename: A
authors.initials: A
authors.lastname: Petrillo
authors.forename: L
authors.initials: L
authors.lastname: Bonomo
authors.forename: A
authors.initials: A
authors.lastname: Carriero
authors.forename: R
authors.initials: R
authors.lastname: Mariani-Costantini
authors.forename: P
authors.initials: P
authors.lastname: Battista
authors.forename: A
authors.initials: A
authors.lastname: Cama
authors.forename: G
authors.initials: G
authors.lastname: Palca
authors.forename: C
authors.initials: C
authors.lastname: Di Maggio
authors.forename: E
authors.initials: E
authors.lastname: D'Andrea
authors.forename: M
authors.initials: M
authors.lastname: Bazzocchi
authors.forename: G E
authors.initials: GE
authors.lastname: Francescutti
authors.forename: C
authors.initials: C
authors.lastname: Zuiani
authors.forename: V
authors.initials: V
authors.lastname: Londero
authors.forename: I
authors.initials: I
authors.lastname: Zunnui
authors.forename: C
authors.initials: C
authors.lastname: Gustavino
authors.forename: M G
authors.initials: MG
authors.lastname: Centurioni
authors.forename: A
authors.initials: A
authors.lastname: Iozzelli
authors.forename: P
authors.initials: P
authors.lastname: Panizza
authors.forename: A
authors.initials: A
authors.lastname: Del Maschio
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D005682:Gadolinium; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009154:Mutation; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D016217:Ultrasonography, Mammary
chemical_list: D005682:Gadolinium