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Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis
BACKGROUND: We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials. METHODS: Sensitivity and specificity of MRI, mammography and the combinatio...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800299/ https://www.ncbi.nlm.nih.gov/pubmed/26908327 http://dx.doi.org/10.1038/bjc.2016.32 |
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author | Phi, Xuan-Anh Saadatmand, Sepideh De Bock, Geertruida H Warner, Ellen Sardanelli, Francesco Leach, Martin O Riedl, Christopher C Trop, Isabelle Hooning, Maartje J Mandel, Rodica Santoro, Filippo Kwan-Lim, Gek Helbich, Thomas H Tilanus-Linthorst, Madeleine MA van den Heuvel, Edwin R Houssami, Nehmat |
author_facet | Phi, Xuan-Anh Saadatmand, Sepideh De Bock, Geertruida H Warner, Ellen Sardanelli, Francesco Leach, Martin O Riedl, Christopher C Trop, Isabelle Hooning, Maartje J Mandel, Rodica Santoro, Filippo Kwan-Lim, Gek Helbich, Thomas H Tilanus-Linthorst, Madeleine MA van den Heuvel, Edwin R Houssami, Nehmat |
author_sort | Phi, Xuan-Anh |
collection | PubMed |
description | BACKGROUND: We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials. METHODS: Sensitivity and specificity of MRI, mammography and the combination of these tests were compared stratified for BRCA mutation and age using generalised linear mixed models with random effect for studies. Number of screens needed (NSN) for additional mammography-only detected cancer was estimated. RESULTS: In BRCA1/2 mutation carriers of all ages (BRCA1=1219 and BRCA2=732), adding mammography to MRI did not significantly increase screening sensitivity (increased by 3.9% in BRCA1 and 12.6% in BRCA2 mutation carriers, P>0.05). However, in women with BRCA2 mutation younger than 40 years, one-third of breast cancers were detected by mammography only. Number of screens needed for mammography to detect one breast cancer not detected by MRI was much higher for BRCA1 compared with BRCA2 mutation carriers at initial and repeat screening. CONCLUSIONS: Additional screening sensitivity from mammography above that from MRI is limited in BRCA1 mutation carriers, whereas mammography contributes to screening sensitivity in BRCA2 mutation carriers, especially those ⩽40 years. The evidence from our work highlights that a differential screening schedule by BRCA status is worth considering. |
format | Online Article Text |
id | pubmed-4800299 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-48002992017-03-15 Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis Phi, Xuan-Anh Saadatmand, Sepideh De Bock, Geertruida H Warner, Ellen Sardanelli, Francesco Leach, Martin O Riedl, Christopher C Trop, Isabelle Hooning, Maartje J Mandel, Rodica Santoro, Filippo Kwan-Lim, Gek Helbich, Thomas H Tilanus-Linthorst, Madeleine MA van den Heuvel, Edwin R Houssami, Nehmat Br J Cancer Clinical Study BACKGROUND: We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials. METHODS: Sensitivity and specificity of MRI, mammography and the combination of these tests were compared stratified for BRCA mutation and age using generalised linear mixed models with random effect for studies. Number of screens needed (NSN) for additional mammography-only detected cancer was estimated. RESULTS: In BRCA1/2 mutation carriers of all ages (BRCA1=1219 and BRCA2=732), adding mammography to MRI did not significantly increase screening sensitivity (increased by 3.9% in BRCA1 and 12.6% in BRCA2 mutation carriers, P>0.05). However, in women with BRCA2 mutation younger than 40 years, one-third of breast cancers were detected by mammography only. Number of screens needed for mammography to detect one breast cancer not detected by MRI was much higher for BRCA1 compared with BRCA2 mutation carriers at initial and repeat screening. CONCLUSIONS: Additional screening sensitivity from mammography above that from MRI is limited in BRCA1 mutation carriers, whereas mammography contributes to screening sensitivity in BRCA2 mutation carriers, especially those ⩽40 years. The evidence from our work highlights that a differential screening schedule by BRCA status is worth considering. Nature Publishing Group 2016-03-15 2016-02-23 /pmc/articles/PMC4800299/ /pubmed/26908327 http://dx.doi.org/10.1038/bjc.2016.32 Text en Copyright © 2016 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/4.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ |
spellingShingle | Clinical Study Phi, Xuan-Anh Saadatmand, Sepideh De Bock, Geertruida H Warner, Ellen Sardanelli, Francesco Leach, Martin O Riedl, Christopher C Trop, Isabelle Hooning, Maartje J Mandel, Rodica Santoro, Filippo Kwan-Lim, Gek Helbich, Thomas H Tilanus-Linthorst, Madeleine MA van den Heuvel, Edwin R Houssami, Nehmat Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title | Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title_full | Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title_fullStr | Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title_full_unstemmed | Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title_short | Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis |
title_sort | contribution of mammography to mri screening in brca mutation carriers by brca status and age: individual patient data meta-analysis |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800299/ https://www.ncbi.nlm.nih.gov/pubmed/26908327 http://dx.doi.org/10.1038/bjc.2016.32 |
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