title: Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the International Breast Magnetic Resonance Consortium (IBMC) trial.
abstract: OBJECTIVE
  To estimate the added cancer yield of magnetic resonance imaging (MRI) over mammography in the contralateral breast of patients with a recent diagnosis of breast cancer.
  
  
  METHODS
  We conducted a prospective, international study of mammography and MRI in women with a recent diagnosis of unilateral breast cancer. Each subject received a mammogram, clinical breast exam (CBE), and MRI of the unaffected breast within a 90 day time period. Definitive diagnosis of suspicious findings was determined through biopsy and central pathology review.
  
  
  RESULTS
  Of the 103 eligible women included in study analyses, MRI detected 4 cancers in the contralateral breast while mammography detected none. MRI resulted in 12% (95% CI, 6%-20%) of women recommended for biopsy and 10% of women undergoing additional biopsy. The added cancer yield of MRI was 4% (95% CI, 1%-10%) and the positive predictive value of an abnormal MRI was 33% (95% CI, 10%-65%). Forty percent (4/10) of the biopsies performed based on the MRI recommendation were positive for malignancy.
  
  
  CONCLUSIONS
  In women with a recent breast cancer diagnosis, approximately 4% will have an otherwise occult invasive breast cancer detected in the opposite breast by MRI alone.
authors.affiliation: Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington 98109, USA. lehman@seattlecca.org
authors.forename: Constance D
authors.initials: CD
authors.lastname: Lehman
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Blume
authors.forename: David
authors.initials: D
authors.lastname: Thickman
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Etta
authors.initials: E
authors.lastname: Pisano
authors.forename: Christiane
authors.initials: C
authors.lastname: Kuhl
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Julian
authors.forename: Nola
authors.initials: N
authors.lastname: Hylton
authors.forename: Paul
authors.initials: P
authors.lastname: Weatherall
authors.forename: Michael
authors.initials: M
authors.lastname: O'loughlin
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Schnitt
authors.forename: Constantine
authors.initials: C
authors.lastname: Gatsonis
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Schnall
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012680:Sensitivity and Specificity