The researchers in a new study have found that 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.
Dr.Vreemann S and colleagues have conducted a retrospective single-center study 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. The study has been published in the Journal of Breast Cancer Research.
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 researchers did a retrospective single-center study which evaluated 6553 screening rounds in 2026 women at increased risk of breast cancer. 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). Of a total of 125 screen-detected breast cancers, 112 were detected by MRI and 66 by mammography
Key study findings:
- 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.
The study concluded that 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. However, the benefit appears slightly larger in women over 50 years of age without BRCA mutation but there is also a significant increase in false-positive findings in these women.
For reference log on to https://doi.org/10.1186/s13058-018-1019-6
Dr. Kamal Kant Kohli
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