Women
with a history of breast cancer may benefit from an abbreviated MRI
In
a study published June 14 in Radiology, South Korean researchers discovered
that abbreviated breast MRI offers equal specificity and sensitivity to
full-protocol MRI in diagnosing breast cancer in women with a personal history
of the disease.
In
two separate cohorts of 726 patients, researchers led by Soo-Yeon Kim, PhD,
compared the performance of shortened MRI versus full-protocol MRI. They
discovered that the group of individuals who received shortened MRI had a
statistically significant improvement in specificity. Although the findings of
shortened MRI were superior in terms of sensitivity, cancer detection rate,
interval cancer detection rate, and positive predictive value, they were not
statistically significant.
"When
screening MRI is considered for women with a personal history of breast cancer,
abbreviated MRI, with its shorter scan time, might replace full-protocol
MRI," Kim et colleagues noted.
Supplemental
MRI screening can aid in the detection of aggressive breast tumours that aren't
visible on mammography. It is, however, vulnerable to false-positive biopsies,
expensive costs, and lengthy scan durations. Because of these difficulties, it
is only recommended for women who have a lifetime risk of breast cancer of at
least 20%.
There
is no consensus among researchers on the appropriate use of MRI screening for
women who have a personal history of breast cancer. In women with thick
breasts, a previous retrospective study has shown that an abridged MRI protocol
can detect breast malignancies at a higher rate than digital breast
tomosynthesis (DBT), with equivalent results to full-protocol MRI.
There
is no consensus among researchers on the appropriate use of MRI screening for
women who have a personal history of breast cancer. In women with thick
breasts, previous retrospective study has shown that an abridged MRI protocol
can detect breast malignancies at a higher rate than digital breast
tomosynthesis (DBT), with equivalent results to full-protocol MRI.
Abbreviated
vs. full MRI protocols for detecting breast cancer
|
|
Full-protocol
MRI |
Abbreviated
MRI |
p-value |
|
Specificity |
86% |
93% |
<0.001 |
|
Sensitivity |
69% |
100% |
0.17 |
|
Cancer
detection rate (per 1,000 exams) |
12 |
21 |
0.29 |
|
Interval
cancer rate (per 1,000 exams) |
5 |
0 |
0.13 |
|
Positive
predictive value |
41% |
61% |
0.16 |
Researchers also discovered that 93 per
cent (14 of 15) of tumours detected using an abridged MRI were node-negative
T1-invasive malignancies (n = 6) or ductal carcinoma in situ (n = 8).
They
also found that abridged MRI for BI-RADS category 3 had a short-term follow-up
rate of 5% (36 of 726 tests), compared to 12% (84 of 726 exams) for
full-protocol MRI (p = 0.001). Meanwhile, the DCIS detection rate was similar
between the two groups, with 11% for the shortened group and 7% for the
full-protocol group (p = 0.58).
Because
their investigation was not a randomised controlled trial with long-term
follow-up, the researchers were unable to give information on breast cancer
mortality or suspected overdiagnosis, according to the authors. Future studies
should involve a variety of screening populations to evaluate the
generalizability of their findings, they said.
Nonetheless,
the researchers concluded that among women with a personal history of breast
cancer, shorter MRI procedures can be offered as a replacement for full
protocols.