title: Sensitivity of MRI versus conventional screening in the diagnosis of BRCA-associated breast cancer in a national prospective series.
abstract: We wanted to compare the sensitivities of breast magnetic resonance imaging (MRI) and the conventional screening programme consisting of mammography (XRM) +/- ultrasound for early diagnosis of breast cancer in BRCA1/2 mutation carriers. BRCA1/2 mutation carriers were examined prospectively by both breast MRI and XRM +/- ultrasound. Eight hundred and sixty-seven MRI examinations were carried out in 445 BRCA1 and 46 BRCA2 mutation carriers. A total of 25 cancers were observed, five (20%) as interval cancers. At the time of diagnosis, sensitivity to detect cancer was 19/22=86% for MRI and 12/24=50% for XRM. Twenty-one were examined by both methods at the time of diagnosis. In the19 BRCA1 mutation carriers among them, MRI had a sensitivity of 1/3(33%) to diagnose DCIS and 15/16 (94%) among the invasive cancers. For XRM the sensitivities were 1/3(33%) for DCIS, 3/7(42%) for pT1b, 3/6(50%) for pT1c, and 3/3/100%) for pT2. In the two BRCA2 mutation carriers, both were demonstrated by breast MRI, neither was detected by XRM. Breast MRI had increased sensitivity compared to XRM to diagnose all cancers staged less than pT2.
authors.affiliation: Department of Circulation and Medical Imaging, the Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. anne.i.hagen@ntnu.no
authors.forename: Anne I
authors.initials: AI
authors.lastname: Hagen
authors.forename: Kjell Arne
authors.initials: KA
authors.lastname: Kvistad
authors.forename: Lovise
authors.initials: L
authors.lastname: Maehle
authors.forename: Marit Muri
authors.initials: MM
authors.lastname: Holmen
authors.forename: Hildegunn
authors.initials: H
authors.lastname: Aase
authors.forename: Bodil
authors.initials: B
authors.lastname: Styr
authors.forename: Anita
authors.initials: A
authors.lastname: Vabø
authors.forename: Jaran
authors.initials: J
authors.lastname: Apold
authors.forename: Per
authors.initials: P
authors.lastname: Skaane
authors.forename: Pål
authors.initials: P
authors.lastname: Møller
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway; D011446:Prospective Studies; D012680:Sensitivity and Specificity