Reconsider Necessity of Screening Mammography Plus Screening MRI

Women at high risk for developing breast cancer do not benefit from adding screening mammography to screening MR imaging, according to a study published in Radiology.

Researchers from Canada and Australia performed a retrospective review to evaluate the value of mammography in detecting breast cancer in high-risk women undergoing screening breast MR imaging. They obtained data from 3,934 screening studies from 1,249 high-risk women; 1,977 studies were screening MR imaging examinations and 1,957 studies were screening mammograms. All were performed between January 2012 and July 2014. Performance measures including recall and cancer detection rates, sensitivity, specificity, and positive predictive values were calculated for both mammography and MR imaging.

The results showed 45 cancers were diagnosed overall, 33 invasive and 12 ductal carcinomas in situ. Forty-three of the cancers were detected with MR imaging alone and 14 with both mammography and MR imaging. Additional tests (further imaging and/or biopsy) were recommended in 461 screening MR imaging studies, a recall rate of 23.3%, and mammography required further testing in 217 cases, a recall rate of 11.1%.

Further findings included:

The researchers concluded that adding screening mammography to screening MR imaging for women who are high risk for breast cancer did not have added value in detection of breast cancer. “Routine use of screening mammography in women undergoing screening breast MR imaging warrants reconsideration,” they wrote.