Following breast cancer treatment, women who have access to breast MRI may safely forgo additional mammographic or digital breast tomosynthesis follow-up.
Study results presented at the Radiological Society of North America (RSNA) 2021 Annual Meeting suggest that magnetic resonance imaging (MRI) alone is a successful method for the follow-up in women who undergo breast-conserving treatment and ensures early detection of recurrent cancer.
“Women in the follow-up after breast cancer who have access to breast MRI may safely forgo additional mammographic or digital breast tomosynthesis follow-up,” the authors wrote.
The results were presented by Vanessa Raaff, Ph.D., of the department of diagnostic and interventional radiology, RWTH Aachen University Hospital in Germany.
For follow-up after breast conserving treatment, serial two-view mammography is recommended, possibly accompanied by targeted ultrasound. As breast MRI has been shown to be useful to improve breast cancer detection of recurrence in patients after breast conserving treatment, the researchers investigated the usefulness of MRI as a standalone imaging method for this purpose.
Between January 2011 and March 2021, a total of 426 women who had undergone MRI alone for routine follow-up after breast conserving surgery were included. The women started MRI screening at a median of two years after treatment and underwent MRI screening annually. Validation of the last negative MRI study was achieved by tomosynthesis plus clinical examination in 137 women and/or by clinical follow-up for at least two years in 289 women.
The women were followed by 1,553 MRI studies, covering a total 1,727 women years. Across the entire follow-up period, MRI was positive in 108/1,553 examinations (6.9%) and in 85/426 women (19.9%). Recurrent breast cancer was confirmed in 64/108 MRI studies and in 55/85 women, for a positive predictive value of 59.3% per positive MRI study and 64.7% per patient.
The cancer-detection-rate was 37 per 1000 women years. Recurrent cancers were detected on average 8.9 years after breast conserving treatment. Of the 64 recurrent cancers, 17.2% were ductal carcinoma in situ and 82.8% were invasive. The mean size of invasive recurrent cancer was 11.4 mm, most frequently staged as T1b, followed by T1c.
“None of the women received a diagnosis of breast cancer in between MRI screening rounds, or within the two-year follow up after the respective last negative MRI, or upon digital breast tomosynthesis after the last study MRI,” the authors wrote.
For more coverage of RSNA 2021, click here.
Stay at the forefront of radiology with the Diagnostic Imaging newsletter, delivering the latest news, clinical insights, and imaging advancements for today’s radiologists.
The Reading Room Podcast: A Closer Look at Remote MRI Safety, Part 2
July 25th 2025In the second of a multi-part podcast episode, Emanuel Kanal, M.D. and Tobias Gilk, MRSO, MRSE, share their perspectives on remote MRI safety protocols for ensuring screening accuracy and adherence to conditional implant guidelines as well as a rapid and effective response to adverse events.
The Reading Room Podcast: Current and Emerging Insights on Abbreviated Breast MRI, Part 2
July 23rd 2025In the second part of a multi-part podcast episode, Stamatia Destounis, MD, Emily Conant, MD and Habib Rahbar, MD, discuss key sequences for abbreviated breast MRI and how it stacks up to other breast cancer screening modalities.