title: Breast MRI screening in patients with increased familial and/or genetic risk for breast cancer: a preliminary experience.
abstract: OBJECTIVE
  Breast cancer is the most common cancer affecting women, and it is associated with or due to a genetic predisposition in 5%-10% of the cases. Owing to the higher risk of developing breast cancer and the early onset of the disease in women proved or suspected to be carriers of a breast cancer susceptibility gene, a dedicated screening should be offered as a less invasive approach with the otherwise suggested prophylactic mastectomy. This should be optimized in order to overcome the limitations of conventional breast imaging with the application of new technologies such as breast magnetic resonance imaging.
  
  
  METHODS
  A diagnostic protocol for routine control in patients at high risk of developing breast cancer has been prepared. Within a 7-month period, 23 patients suspected or proved to carry a breast cancer susceptibility gene underwent breast magnetic resonance imaging.
  
  
  RESULTS
  Four breast cancers were identified with breast magnetic resonance imaging. In these cases, mammography was negative because of the density of the parenchyma or for its fibroglandular pattern. Ultrasound was negative in 2 cases, not specific for malignancy in 1 case, and considered as only possibly malignant but with biopsy recommendation on the basis of magnetic resonance findings in the last one. Clinical analysis was positive for a mass in 2 cases.
  
  
  CONCLUSIONS
  The accuracy of breast magnetic resonance imaging is known to be higher than that of conventional imaging in the study of breast parenchyma. High spatial resolution, no breast density influence and multiplanarity can give more detailed information about the smaller lesions and the right extension of the disease. Preliminary studies where breast magnetic resonance imaging is performed in addition to mammography within this group of patients are encouraging. We also believe that the application of breast magnetic resonance imaging can be very useful in the detection of cancer as early as possible with the aim to obtain the highest chance of survival after treatment.
authors.affiliation: Unit of Diagnostic Radiology A, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. trecate@istitutotumori.mi.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Trecate
authors.forename: Daniele
authors.initials: D
authors.lastname: Vergnaghi
authors.forename: Silvana
authors.initials: S
authors.lastname: Bergonzi
authors.forename: Tiziana
authors.initials: T
authors.lastname: De Simone
authors.forename: Elena
authors.initials: E
authors.lastname: Fengoni
authors.forename: Claudia
authors.initials: C
authors.lastname: Costa
authors.forename: Gianbattista
authors.initials: G
authors.lastname: Spatti
authors.forename: Barbara
authors.initials: B
authors.lastname: Pasini
authors.forename: Siranoush
authors.initials: S
authors.lastname: Manoukian
authors.forename: Franca
authors.initials: F
authors.lastname: Podo
authors.forename: Renato
authors.initials: R
authors.lastname: Musumeci
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged