Ck. Kuhl et al., Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: Preliminary results, RADIOLOGY, 215(1), 2000, pp. 267-279
Citations number
58
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To compare magnetic resonance (MR) imaging with conventional imagi
ng in screening high-risk women.
MATERIALS AND METHODS: This prospective trial included 192 asymptomatic and
six symptomatic women who, on the basis of personal or family history or g
enetic analysis, were suspected or proved to carry a breast cancer suscepti
bility gene.
RESULTS: Fifteen breast cancers were identified: nine in the 192 asymptomat
ic;women (six in the first and three in the second screening round) and six
in the :symptomatic patients. Concerning the asymptomatic women, four of t
he nine breast cancers were detected and correctly classified with mammogra
phy and ultrasonography (US) combined; another two cancers were visible as
well-circumscribed masses and were diagnosed as fibroadenomas. MR imaging a
llowed the correct classification and local staging of all nine cancers. In
105 asymptomatic women with validation of the 1st-year screening results,
the sensitivities of mammography, US, and MR imaging were 33%, 33% (mammogr
aphy and US combined, 44%), and 100%, respectively; the positive predictive
values were 30%, 12%, and 64%, respectively.
CONCLUSION: The accuracy of MR imaging is significantly higher than that of
conventional imaging in screening high-risk women. Difficulties can be cau
sed by an atypical manifestation of hereditary breast cancers at both conve
ntional and MR imaging and by contrast material enhancement associated with
hormonal stimulation.