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Younger Women Who Had Breast Conservation Therapy and MRI Screening

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Annual MRI screening and cancer detection among women under 50 who had breast conservation therapy following breast cancer.

Adding MR image screening to annual mammography for younger women who have had breast conservation therapy helps detect early-stage cancers, according to an article in JAMA Oncology.

Researchers from Korea performed a prospective, non-randomized study to determine the cancer yield and tumor characteristics of combined mammography with MRI or ultrasonography screening in women who were 50 years old or younger and who had undergone breast conservation therapy for breast cancer.

A total of 754 women were included in the study. All were younger than 50 when they received their initial diagnosis of breast cancer and had undergone breast conservation therapy. For the study, the women underwent three annual MRI, mammography, and ultrasound screenings of both breasts, with a follow-up of 12 months. There were in all, 2,065 screening examinations.

The results showed 17 diagnosed cancers, 13 (76%) of which were stage 0 or stage 1:

 
Mammography plus MRI
Mammography Alone
Overall Cancer Detection Rate
8.2 per 1,000 women
4.4 per 1,000 women
Sensitivity
100%
53%

 

 

 

 

 

After ultrasonography was added, the cancer detection rate was higher than the rate by mammography alone (6.8 versus 4.4 per 1,000). The specificity of mammography with MRI or ultrasonography was lower than that by mammography alone (87% or 88% versus 96%). No interval cancer was found.

The researchers concluded that among women who were 50 or younger when undergoing breast conservation therapy after diagnosis with breast cancer, adding MR imaging to annual screening helps detect early-stage but biologically aggressive breast cancers at acceptable specificity. “Results from this study can inform patient decision making on screening methods after breast conservation therapy,” they said.

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