High-risk women benefitfrom mammography, MRI

Alternating two screening modalities pays off for women with high genetic likelihood of breast cancer Alternating MRI with mammography every six months picks up breast cancers missed when mammography is performed alone for high-risk women.

The two screening modalities are alternated in many special programs for women with confirmed BRCA1 and BRCA2 genetic mutations giving them an exceptionally high risk for developing breast cancer. Until now, no one has established a scientific basis for adopting the tactic.

Dr. Huong Le-Petross, an assistant professor of radiology at M.D. Anderson Cancer Center in Houston, reviewed the medical records of 334 consecutive women. Of those patients, 26% (86) underwent annual screening mammography and MRI, alternating every six months. The rest underwent prophylactic mastectomies or were treated with chemoprevention.

Overall, the researchers identified nine cancers in seven women with screening MRI: six invasive ductal, one invasive lobular, and two ductal carcinomas in situ.

Four of these cancers were identified only with MRI, four were identified with both MRI and mammography, and one was missed by both modalities before diagnosis after prophylactic mastectomy.

“The global picture is that MRI can pick up cancers that mammography cannot,” Le-Petross said.