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Routine Mammography Not Necessary in Addition to Routine MRI

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Routine mammography does not detect more cancers among high-risk women who undergo annual screening with MRI.

Adding screening mammography to annual screening MR imaging for women at high risk for breast cancer does not increase cancer detection rates, according to a study published in Radiology.

Researchers from Canada performed a retrospective review to evaluate the value of mammography in detecting breast cancer in high-risk women undergoing screening breast MR imaging.

The researchers evaluated 3,934 screening studies (1,977 screening MR imaging examinations and 1,957 screening mammograms) performed in 1,249 high-risk women. The performance measures included recall and cancer detection rates, sensitivity, specificity, and positive predictive values were calculated for both mammography and MR imaging.

The results showed a total of 45 cancers (33 invasive and 12 ductal carcinomas in situ) were diagnosed. Forty-three were seen with MR imaging and 14 with both mammography and MR imaging.

 
MRI
Mammography
Additional testing recommended/recall rate
461 studies/23.2%
217 studies (11.1%)
Cancer detection rate per 1,000 examinations
21.8 cancers
7.2 cancers
Sensitivity
96%
31%
Specificity
78%
89%
Positive predictive value
9.3%
6.5%

 

The researchers concluded that contemporaneous screening mammography did not add value in detection of breast cancer for women who undergo screening MR imaging. Routine use of screening mammography in women undergoing screening breast MR imaging warrants reconsideration, they wrote.

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