The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers

PURPOSE: BRCA2 mutation carriers are offered annual breast screening with MRI and mammography. The aim of this study was to investigate the supplemental value of mammographic screening over MRI screening alone. METHODS: In this multicenter study, proven BRCA2 mutation carriers, who developed breast...

Descripción completa

Detalles Bibliográficos
Autores principales: Obdeijn, Inge-Marie, Mann, Ritse M., Loo, Claudette C. E., Lobbes, Marc, Voormolen, Eleonora M. C., van Deurzen, Carolien H. M., de Bock, Geertruida, Hooning, Maartje J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220868/
https://www.ncbi.nlm.nih.gov/pubmed/32333294
http://dx.doi.org/10.1007/s10549-020-05642-1
_version_ 1783533250605481984
author Obdeijn, Inge-Marie
Mann, Ritse M.
Loo, Claudette C. E.
Lobbes, Marc
Voormolen, Eleonora M. C.
van Deurzen, Carolien H. M.
de Bock, Geertruida
Hooning, Maartje J.
author_facet Obdeijn, Inge-Marie
Mann, Ritse M.
Loo, Claudette C. E.
Lobbes, Marc
Voormolen, Eleonora M. C.
van Deurzen, Carolien H. M.
de Bock, Geertruida
Hooning, Maartje J.
author_sort Obdeijn, Inge-Marie
collection PubMed
description PURPOSE: BRCA2 mutation carriers are offered annual breast screening with MRI and mammography. The aim of this study was to investigate the supplemental value of mammographic screening over MRI screening alone. METHODS: In this multicenter study, proven BRCA2 mutation carriers, who developed breast cancer during screening using both digital mammography and state-of-art breast MRI, were identified. Clinical data were reviewed to classify cases in screen-detected and interval cancers. Imaging was reviewed to assess the diagnostic value of mammography and MRI, using the Breast Imaging and Data System (BI-RADS) classification allocated at the time of diagnosis. RESULTS: From January 2003 till March 2019, 62 invasive breast cancers and 23 ductal carcinomas in situ were diagnosed in 83 BRCA2 mutation carriers under surveillance. Overall screening sensitivity was 95.2% (81/85). Four interval cancers occurred (4.7% (4/85)). MRI detected 73 of 85 breast cancers (sensitivity 85.8%) and 42 mammography (sensitivity 49.9%) (p < 0.001). Eight mammography-only lesions occurred. In 1 of 17 women younger than 40 years, a 6-mm grade 3 DCIS, retrospectively visible on MRI, was detected with mammography only in a 38-year-old woman. The other 7 mammography-only breast cancers were diagnosed in women aged 50 years and older, increasing sensitivity in this subgroup from 79.5% (35/44) to 95.5% (42/44) (p ≤ 0.001). CONCLUSIONS: In BRCA2 mutation carriers younger than 40 years, the benefit of mammographic screening over MRI was very small. In carriers of 50 years and older, mammographic screening contributed significantly. Hence, we propose to postpone mammographic screening in BRCA2 mutation carriers to at least age 40.
format Online
Article
Text
id pubmed-7220868
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-72208682020-05-14 The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers Obdeijn, Inge-Marie Mann, Ritse M. Loo, Claudette C. E. Lobbes, Marc Voormolen, Eleonora M. C. van Deurzen, Carolien H. M. de Bock, Geertruida Hooning, Maartje J. Breast Cancer Res Treat Clinical Trial PURPOSE: BRCA2 mutation carriers are offered annual breast screening with MRI and mammography. The aim of this study was to investigate the supplemental value of mammographic screening over MRI screening alone. METHODS: In this multicenter study, proven BRCA2 mutation carriers, who developed breast cancer during screening using both digital mammography and state-of-art breast MRI, were identified. Clinical data were reviewed to classify cases in screen-detected and interval cancers. Imaging was reviewed to assess the diagnostic value of mammography and MRI, using the Breast Imaging and Data System (BI-RADS) classification allocated at the time of diagnosis. RESULTS: From January 2003 till March 2019, 62 invasive breast cancers and 23 ductal carcinomas in situ were diagnosed in 83 BRCA2 mutation carriers under surveillance. Overall screening sensitivity was 95.2% (81/85). Four interval cancers occurred (4.7% (4/85)). MRI detected 73 of 85 breast cancers (sensitivity 85.8%) and 42 mammography (sensitivity 49.9%) (p < 0.001). Eight mammography-only lesions occurred. In 1 of 17 women younger than 40 years, a 6-mm grade 3 DCIS, retrospectively visible on MRI, was detected with mammography only in a 38-year-old woman. The other 7 mammography-only breast cancers were diagnosed in women aged 50 years and older, increasing sensitivity in this subgroup from 79.5% (35/44) to 95.5% (42/44) (p ≤ 0.001). CONCLUSIONS: In BRCA2 mutation carriers younger than 40 years, the benefit of mammographic screening over MRI was very small. In carriers of 50 years and older, mammographic screening contributed significantly. Hence, we propose to postpone mammographic screening in BRCA2 mutation carriers to at least age 40. Springer US 2020-04-24 2020 /pmc/articles/PMC7220868/ /pubmed/32333294 http://dx.doi.org/10.1007/s10549-020-05642-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Clinical Trial
Obdeijn, Inge-Marie
Mann, Ritse M.
Loo, Claudette C. E.
Lobbes, Marc
Voormolen, Eleonora M. C.
van Deurzen, Carolien H. M.
de Bock, Geertruida
Hooning, Maartje J.
The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title_full The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title_fullStr The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title_full_unstemmed The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title_short The supplemental value of mammographic screening over breast MRI alone in BRCA2 mutation carriers
title_sort supplemental value of mammographic screening over breast mri alone in brca2 mutation carriers
topic Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220868/
https://www.ncbi.nlm.nih.gov/pubmed/32333294
http://dx.doi.org/10.1007/s10549-020-05642-1
work_keys_str_mv AT obdeijningemarie thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT mannritsem thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT looclaudettece thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT lobbesmarc thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT voormoleneleonoramc thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT vandeurzencarolienhm thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT debockgeertruida thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT hooningmaartjej thesupplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT obdeijningemarie supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT mannritsem supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT looclaudettece supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT lobbesmarc supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT voormoleneleonoramc supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT vandeurzencarolienhm supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT debockgeertruida supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers
AT hooningmaartjej supplementalvalueofmammographicscreeningoverbreastmrialoneinbrca2mutationcarriers