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.
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.
Lehman
Constance D
CD
Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington 98109, USA. lehman@seattlecca.org
Blume
Jeffrey D
JD
Thickman
David
D
Bluemke
David A
DA
Pisano
Etta
E
Kuhl
Christiane
C
Julian
Thomas B
TB
Hylton
Nola
N
Weatherall
Paul
P
O'loughlin
Michael
M
Schnitt
Stuart J
SJ
Gatsonis
Constantine
C
Schnall
Mitchell D
MD
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