A history of breast conservation therapy (BCT) in patients could be a reasonable indication for single-screening breast MRI in women younger than 50, according to a study published online Mar. 17 by Radiology.
While breast conservation therapy is commonly used in women with early breast cancers, many patients who undergo BCT are at a higher risk of developing second breast cancers. Detection of these cancers at the asymptomatic phase can improve survival rates, according to lead author Hye Mi Gweon, MD, of the Seoul National University Hospital in Korea, and colleagues. However, recommendations are conflicted regarding the use of screening breast MRI in women with histories of BCT and data demonstrating its use one way or another are scarce. The authors examined the outcomes of single-screening breast MRI in women with a history of BCT for breast cancers and who had previous negative mammography and ultrasonographic results.
The retrospective study included 607 women who underwent 932 screening MRI exams. Of these exams, 91.8 percent were preoperative. Gweon and colleagues investigated cancer detection rate, characteristics of the detected cancers, the positive predictive value, sensitivity and specificity. The study’s results revealed an overall cancer detective rate of 18.1 per 1,000 women. Of the 11 cancers found, eight were invasive ductal carcinoma and three were ductal carcinoma in situ.
The sensitivity was found to be 91.7 percent and the specificity was 82.2 percent. The positive predictive values for recall and biopsy were 9.4 percent and 43.5 percent, respectively. Independent factors associated with women with MR-detected cancers were being younger than 50 years old and have more than a 24 month interval between initial surgery and screening MRI.
“In view of the high cancer detection yields of our study and of previous studies, it may be appropriate to recommend screening MR imaging in these women with a personal history of breast cancer,” wrote Gwoen and colleagues.