Biannual MRI tops mammograms for women with genetic breast cancer risk

A team from the University of Chicago Medicine and University of Washington in Seattle found undergoing MRI scans every six months better detected early breast cancer in young women with a high genetic risk for the disease compared to mammograms.

The results, first presented at the 2017 annual San Antonio Breast Cancer Symposium, but were released online Aug. 28 in Clinical Cancer Research.

"This study demonstrates for the first time that aggressive breast cancers can be caught early, without excessive recalls or biopsies," said corresponding author Olufunmilayo Olopade, MD, in a University of Chicago release published last year.

Olopade and colleagues enrolled 295 women with a lifetime risk for breast cancer greater than 20 percent. More than half—53 percent—had one of 11 known breast cancer-related genetic abnormalities. Seventy-five had BRCA1 mutations, and 61 women had BRCA2 mutations.

Participants underwent a clinical breast exam and dynamic contrast-enhanced MRI (DCE-MRI) every six months in addition to a digital mammogram once a year. Researchers found 17 patients with cancer—four ductal carcinomas in situ and 13 early stage breast cancers.

Of the 17 patients, 15 cancers occurred in those with pathogenic mutations.

In those with a genetic risk for the disease mammography provided no additional benefit to bi-annual DCE-MRI, according to authors.

And while MRI can more accurately identify invasive tumors less than one centimeter—ideal for early detection—it’s costs remain much higher than that of mammography.

"MRI is much more sensitive than mammography. It can find invasive breast cancers sooner than mammograms and it can rule out abnormalities that appear suspicious on a mammogram,” said Gregory Karczmar, PhD, and an author of the study. “Unfortunately, MRI is much too expensive for routine screening."