Breast MRI may result in extra biopsies than mammography for breast cancer diagnosis

Breast MRI leads to higher biopsy and cancer detection rates compared with mammography with no significant variation in sensitivity or interval cancers, pointed out a study published in radiology.

A biopsy is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease. Most of the biopsies involve entirely pain-free and low-risk procedures. Depending on your situation, a piece of skin, tissue, organ, or suspected tumor is surgically removed. Frequent biopsies carry the risk of infection or bleeding.

This observational cohort study used prospectively collected data and included 13 266 women age 18 years and older (mean age, 60 years ± 13) with stage 0–III breast cancer who underwent 33 938 mammographic examinations and 2506 breast MRI examinations from 2005 to 2012 in the Breast Cancer Surveillance Consortium. Women were categorized into two groups: mammography alone or breast MRI. Performance measures were calculated by using end-of-day assessment and occurrence of second breast cancer events within 1 year of imaging. Logistic regression was used to compare performance for breast MRI versus mammography alone, adjusting for women, examination, and primary breast cancer characteristics. The analysis was conducted on a pre-examination basis.

Breast MRI was associated with younger age at diagnosis, chemotherapy, and higher education and income. Raw performance measures for breast MRI versus mammography were as follows, respectively: cancer detection rates, 10.8 versus 8.2 per 1000 examinations; sensitivity, 61.4% versus 70.3%; and biopsy rate, 10.1% versus 4.0%. In multivariable models, breast MRI was associated with higher biopsy rate (odds ratio [OR], and cancer detection rate than mammography alone. However, there were no differences in sensitivity or interval cancer rate.

The study concluded that a comparison of the performance of surveillance breast MRI with mammography must account for patient characteristics. Whereas breast MRI leads to higher biopsy and cancer detection rates, there were no significant differences in sensitivity or interval cancers compared with mammography.

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https://doi.org/10.1148/radiol.2019182475