title: Screening MRI in Women With a Personal History of Breast Cancer.
abstract: BACKGROUND
  Screening MRI is recommended for individuals at high risk for breast cancer, based on genetic risk or family history (GFH); however, there is insufficient evidence to support screening MRI for women with a personal history (PH) of breast cancer. We compared screening MRI performance in women with PH vs GFH of breast cancer.
  
  
  METHODS
  We analyzed case-series registry data, collected at time of MRI and at 12-month follow-up, from our regional Clinical Oncology Data Integration project. MRI performance was compared in women with PH with those with GFH. Chi-square testing was used to identify associations between age, prior history of MRI, and clinical indication with MRI performance; logistic regression was used to determine the combined contribution of these variables in predicting risk of a false-positive exam. All statistical tests were two-sided.
  
  
  RESULTS
  Of 1521 women who underwent screening MRI from July 2004 to November 2011, 915 had PH and 606 had GFH of breast cancer. Overall, MRI sensitivity was 79.4% for all cancers and 88.5% for invasive cancers. False-positive exams were lower in the PH vs GFH groups (12.3% vs 21.6%, P < .001), specificity was higher (94.0% vs 86.0%, P < .001), and sensitivity and cancer detection rate were not statistically different (P > .99). Age (P < .001), prior MRI (P < .001), and clinical indication (P < .001) were individually associated with initial false-positive rate; age and prior MRI remained statistically significant in multivariable modeling (P = .001 and P < .001, respectively).
  
  
  CONCLUSIONS
  MRI performance is superior in women with PH compared with women with GFH. Screening MRI warrants consideration as an adjunct to mammography in women with a PH of breast cancer.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG). clehman@mgh.harvard.edu.
authors.forename: Constance D
authors.initials: CD
authors.lastname: Lehman
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Janie M
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Wendy B
authors.initials: WB
authors.lastname: DeMartini
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Hippe
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Mara H
authors.initials: MH
authors.lastname: Rendi
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Grace
authors.initials: G
authors.lastname: Kalish
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Peggy
authors.initials: P
authors.lastname: Porter
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Julie
authors.initials: J
authors.lastname: Gralow
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, MA (CDL); Department of Radiology, University of Washington Medical Center, Seattle, WA (JML, DSH, GK, SCP); Seattle Cancer Care Alliance, Seattle, WA (JML, SCP); Department of Radiology, University of Wisconsin-Madison, Madison, WI (WBD); Department of Pathology, University of Washington Medical Center, Seattle, WA (MHR); Fred Hutchinson Cancer Research Center, Seattle, WA, (PP, JG); Department of Medical Oncology, University of Washington Medical Center, Seattle, WA (JG).
authors.forename: Savannah C
authors.initials: SC
authors.lastname: Partridge
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity