title: Personal History of Premenopausal Breast Cancer as a Risk Factor for Referral to Screening Breast MRI.
abstract: OBJECTIVE
  The purpose of this study was to examine whether patients with premenopausal breast cancer history only can benefit from screening breast magnetic resonance imaging (MRI) by comparing them to patients with both a personal and a family history of breast cancer.
  
  
  METHODS
  With Institutional Review Board approval and waiver of informed consent, a retrospective review was conducted to determine patients previously diagnosed with premenopausal breast cancer undergoing screening MRI. From December 2003 to October 31, 2014, a total of 4436 screening MRI examinations were performed; 381 examinations were performed in 131 patients with a personal history (PH) of premenopausal breast cancer. This cohort was evaluated further and revealed 146 examinations in 52 patients with PH only, and 235 examinations in 79 patients with personal history and family history (PHFH). Fisher's exact test was used to compare the distribution between the groups.
  
  
  RESULTS
  Total number of MRI examinations performed per patient ranged from 1 to 10, with an average of 2.9 in the PHFH group and 2.8 in the PH only group. Patient age at time of original diagnosis was significantly different between the groups (P = 0.0391). There were 74 (19.4%) suspicious MRI findings: 27 in the PH only group and 47 in the PHFH group. Fifty-two had needle biopsy tissue sampling performed; three additional lesions were sampled at excision. Malignancy was detected in 27.3%: 53.3% in the PHFH group and 46.7% in the PH only group (P = 0.7963). There was no significant difference when the pathology between the PH only group and the PHFH group was compared (P = 0.5692). Of those diagnosed with cancer, average time between diagnoses was 6.9 years for the PHFH group and 7.1 for the PH only group (range 2-16).
  
  
  CONCLUSIONS
  Patients with a PH only are at a similar risk level as those with additional family history for the development of a subsequent breast cancer and therefore benefit from screening breast MRI, as a similar rate of cancer detection was found in both groups.
authors.affiliation: Elizabeth Wende Breast Care, LLC, 170 Sawgrass Dr., Rochester, NY 14620. Electronic address: sdestounis@ewbc.com.
authors.forename: Stamatia
authors.initials: S
authors.lastname: Destounis
authors.affiliation: Elizabeth Wende Breast Care, LLC, 170 Sawgrass Dr., Rochester, NY 14620.
authors.forename: Andrea
authors.initials: A
authors.lastname: Arieno
authors.affiliation: Elizabeth Wende Breast Care, LLC, 170 Sawgrass Dr., Rochester, NY 14620.
authors.forename: Renee
authors.initials: R
authors.lastname: Morgan
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics; D002278:Carcinoma in Situ / Q000175:diagnosis; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis; D015331:Cohort Studies; D003287:Contrast Media; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008403:Mass Screening; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D017697:Premenopause; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Breast MRI; breast cancer; screening