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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2020
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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 |
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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 |
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