Cargando…
The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI
BACKGROUND: Breast magnetic resonance imaging (MRI) is the most sensitive imaging method for breast cancer detection and is therefore offered as a screening technique to women at increased risk of developing breast cancer. However, mammography is currently added from the age of 30 without proven ben...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091096/ https://www.ncbi.nlm.nih.gov/pubmed/30075794 http://dx.doi.org/10.1186/s13058-018-1019-6 |
_version_ | 1783347331216703488 |
---|---|
author | Vreemann, Suzan van Zelst, Jan C. M. Schlooz-Vries, Margrethe Bult, Peter Hoogerbrugge, Nicoline Karssemeijer, Nico Gubern-Mérida, Albert Mann, Ritse M. |
author_facet | Vreemann, Suzan van Zelst, Jan C. M. Schlooz-Vries, Margrethe Bult, Peter Hoogerbrugge, Nicoline Karssemeijer, Nico Gubern-Mérida, Albert Mann, Ritse M. |
author_sort | Vreemann, Suzan |
collection | PubMed |
description | BACKGROUND: Breast magnetic resonance imaging (MRI) is the most sensitive imaging method for breast cancer detection and is therefore offered as a screening technique to women at increased risk of developing breast cancer. However, mammography is currently added from the age of 30 without proven benefits. The purpose of this study is to investigate the added cancer detection of mammography when breast MRI is available, focusing on the value in women with and without BRCA mutation, and in the age groups above and below 50 years. METHODS: This retrospective single-center study evaluated 6553 screening rounds in 2026 women at increased risk of breast cancer (1 January 2003 to 1 January 2014). Risk category (BRCA mutation versus others at increased risk of breast cancer), age at examination, recall, biopsy, and histopathological diagnosis were recorded. Cancer yield, false positive recall rate (FPR), and false positive biopsy rate (FPB) were calculated using generalized estimating equations for separate age categories (< 40, 40–50, 50–60, ≥ 60 years). Numbers of screens needed to detect an additional breast cancer with mammography (NSN) were calculated for the subgroups. RESULTS: Of a total of 125 screen-detected breast cancers, 112 were detected by MRI and 66 by mammography: 13 cancers were solely detected by mammography, including 8 cases of ductal carcinoma in situ. In BRCA mutation carriers, 3 of 61 cancers were detected only on mammography, while in other women 10 of 64 cases were detected with mammography alone. While 77% of mammography-detected-only cancers were detected in women ≥ 50 years of age, mammography also added more to the FPR in these women. Below 50 years the number of mammographic examinations needed to find an MRI-occult cancer was 1427. CONCLUSIONS: Mammography is of limited added value in terms of cancer detection when breast MRI is available for women of all ages who are at increased risk. While the benefit appears slightly larger in women over 50 years of age without BRCA mutation, there is also a substantial increase in false positive findings in these women. |
format | Online Article Text |
id | pubmed-6091096 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60910962018-08-20 The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI Vreemann, Suzan van Zelst, Jan C. M. Schlooz-Vries, Margrethe Bult, Peter Hoogerbrugge, Nicoline Karssemeijer, Nico Gubern-Mérida, Albert Mann, Ritse M. Breast Cancer Res Research Article BACKGROUND: Breast magnetic resonance imaging (MRI) is the most sensitive imaging method for breast cancer detection and is therefore offered as a screening technique to women at increased risk of developing breast cancer. However, mammography is currently added from the age of 30 without proven benefits. The purpose of this study is to investigate the added cancer detection of mammography when breast MRI is available, focusing on the value in women with and without BRCA mutation, and in the age groups above and below 50 years. METHODS: This retrospective single-center study evaluated 6553 screening rounds in 2026 women at increased risk of breast cancer (1 January 2003 to 1 January 2014). Risk category (BRCA mutation versus others at increased risk of breast cancer), age at examination, recall, biopsy, and histopathological diagnosis were recorded. Cancer yield, false positive recall rate (FPR), and false positive biopsy rate (FPB) were calculated using generalized estimating equations for separate age categories (< 40, 40–50, 50–60, ≥ 60 years). Numbers of screens needed to detect an additional breast cancer with mammography (NSN) were calculated for the subgroups. RESULTS: Of a total of 125 screen-detected breast cancers, 112 were detected by MRI and 66 by mammography: 13 cancers were solely detected by mammography, including 8 cases of ductal carcinoma in situ. In BRCA mutation carriers, 3 of 61 cancers were detected only on mammography, while in other women 10 of 64 cases were detected with mammography alone. While 77% of mammography-detected-only cancers were detected in women ≥ 50 years of age, mammography also added more to the FPR in these women. Below 50 years the number of mammographic examinations needed to find an MRI-occult cancer was 1427. CONCLUSIONS: Mammography is of limited added value in terms of cancer detection when breast MRI is available for women of all ages who are at increased risk. While the benefit appears slightly larger in women over 50 years of age without BRCA mutation, there is also a substantial increase in false positive findings in these women. BioMed Central 2018-08-03 2018 /pmc/articles/PMC6091096/ /pubmed/30075794 http://dx.doi.org/10.1186/s13058-018-1019-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Vreemann, Suzan van Zelst, Jan C. M. Schlooz-Vries, Margrethe Bult, Peter Hoogerbrugge, Nicoline Karssemeijer, Nico Gubern-Mérida, Albert Mann, Ritse M. The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title | The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title_full | The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title_fullStr | The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title_full_unstemmed | The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title_short | The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI |
title_sort | added value of mammography in different age-groups of women with and without brca mutation screened with breast mri |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091096/ https://www.ncbi.nlm.nih.gov/pubmed/30075794 http://dx.doi.org/10.1186/s13058-018-1019-6 |
work_keys_str_mv | AT vreemannsuzan theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT vanzelstjancm theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT schloozvriesmargrethe theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT bultpeter theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT hoogerbruggenicoline theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT karssemeijernico theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT gubernmeridaalbert theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT mannritsem theaddedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT vreemannsuzan addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT vanzelstjancm addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT schloozvriesmargrethe addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT bultpeter addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT hoogerbruggenicoline addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT karssemeijernico addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT gubernmeridaalbert addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri AT mannritsem addedvalueofmammographyindifferentagegroupsofwomenwithandwithoutbrcamutationscreenedwithbreastmri |