title: Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients.
abstract: OBJECTIVE
  To assess the value of breast MRI in size assessment of breast cancers in high risk patients, including those with a BRCA 1 or 2 mutation. Guidelines recommend invariably breast MRI screening for these patients and therapy is thus based on these findings. However, the accuracy of breast MRI for staging purposes is only tested in sporadic cancers.
  
  
  METHODS
  We assessed concordance of radiologic staging using MRI with histopathology in 49 tumors in 46 high risk patients (23 BRCA1, 12 BRCA2 and 11 Non-BRCA patients). The size of the total tumor area (TTA) was compared to pathology. In invasive carcinomas (n=45) the size of the largest focus (LF) was also addressed.
  
  
  RESULTS
  Correlation of MRI measurements with pathology was 0.862 for TTA and 0.793 for LF. TTA was underestimated in 8(16%), overestimated in 5(10%), and correctly measured in 36(73%) cases. LF was underestimated in 4(9%), overestimated in 5(11%), and correctly measured in 36(80%) cases. Impact of BRCA 1 or 2 mutations on the quality of size estimation was not observed.
  
  
  CONCLUSIONS
  Tumor size estimation using breast MRI in high risk patients is comparable to its performance in sporadic cancers. Therefore, breast MRI can safely be used for treatment planning.
authors.affiliation: Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen, The Netherlands. r.mann@rad.umcn.nl
authors.forename: R M
authors.initials: RM
authors.lastname: Mann
authors.forename: P
authors.initials: P
authors.lastname: Bult
authors.forename: H W M
authors.initials: HW
authors.lastname: van Laarhoven
authors.forename: P N
authors.initials: PN
authors.lastname: Span
authors.forename: M
authors.initials: M
authors.lastname: Schlooz
authors.forename: J
authors.initials: J
authors.lastname: Veltman
authors.forename: N
authors.initials: N
authors.lastname: Hoogerbrugge
mesh_terms: D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: BRCA; Breast MRI; Breast cancer; High risk patients; Tumor size