title: Breast MRI screening of women with a personal history of breast cancer.
abstract: OBJECTIVE
  The purpose of this article is to determine the cancer detection and biopsy rate among women who have breast MRI screening solely on the basis of a personal history of breast cancer.
  
  
  METHODS
  This retrospective review of 1,699 breast MRI examinations performed from 1999 to 2001 yielded 144 women with prior breast cancer but no family history who commenced breast MRI screening during that time. Minimal breast cancer was defined as ductal carcinoma in situ (DCIS) or node-negative invasive breast cancer < 1 cm in size.
  
  
  RESULTS
  Of 144 women, 44 (31% [95% CI, 15-29%]) underwent biopsies prompted by MRI examination. Biopsies revealed malignancies in 17 women (12% [95% CI, 7-18%]) and benign findings only in 27 women (19% [95% CI, 13-26%]). Of the 17 women in whom cancer was detected, seven also had benign biopsy results. In total, 18 malignancies were found. One woman had two metachronous cancers. MRI screening resulted in a total of 61 biopsies, with a positive predictive value (PPV) of 39% (95% CI, 27-53%). The malignancies found included 17 carcinomas and one myxoid liposarcoma. Of the 17 cancers, 12 (71%) were invasive, five (29%) were DCIS, and 10 (59%) were minimal breast cancers. Of 17 cancers, 10 were detected by MRI only. The 10 cancers detected by MRI only, versus seven cancers later found by other means, were more likely to be DCIS (4/10 [40%] vs 1/7 [14%]; p = 0.25) or minimal breast cancers (7/10 [70%] vs 3/7 [43%]; p = 0.26).
  
  
  CONCLUSIONS
  We found that breast MRI screening of women with only a personal history of breast cancer was clinically valuable finding malignancies in 12%, with a reasonable biopsy rate (PPV, 39%).
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. brennans@mskcc.org
authors.forename: Sandra
authors.initials: S
authors.lastname: Brennan
authors.forename: Laura
authors.initials: L
authors.lastname: Liberman
authors.forename: D David
authors.initials: DD
authors.lastname: Dershaw
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult