Added Value of Supplemental Screening Breast MRI in Women at Average or Intermediate Breast Cancer Risk Using Abbreviated Protocols

Arvin Arian (1), Nasrin Ahmadinejad (2), Arezoo shafieioun (3), Bita Eslami (4), Jaleh Jamshidi (5), Fahimeh Azizinik (6)
(1) Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Iran, Islamic Republic of,
(2) Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(3) Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(4) Breast Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(5) Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(6) Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of

Abstract

Background: The importance of magnetic resonance imaging (MRI) screening in high-risk women is well-known; however, its utility in women at average or intermediate risk is not well-established. The main purpose of the study was to investigate the added value and cancer detection rate (CDR) of using abbreviated MRI protocols in average or intermediate-risk women.


Methods: A total of 431 asymptomatic women with average or intermediate risk of breast cancer who underwent screening abbreviated MRI from May 2019 to May 2022 were recruited. CDR in screening MRI among average or intermediate-risk women and in low or high-breast composition was calculated. 


Results: In 173 patients with intermediate risk, 5(1.16%) malignant lesions were detected and in 258 average-risk patients, 10(2.32%) added cancers were found in screening abbreviated MRI compared to mammography. Among the 15 malignant lesions, more cancers in high breast composition were detected (11 vs. 4 cases); however, there was no statistically significant difference between the cancer detection rate and breast composition. In intermediate-risk women with high breast composition, 3 (0.69%) malignant lesions, and in average-risk women with high breast composition, 8 (1.85%) added cancers were found.


Conclusion: We provided 3.48% added cancer detection in screening abbreviated MRI compared to mammography. Therefore, screening abbreviated MRI with less image acquisition and interpretation time may be useful as a supplemental screening tool for cancer detection especially in high breast composition.

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References

Alkabban FM, Ferguson T. Breast Cancer. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.; 2023.

Massat NJ, Dibden A, Parmar D, Cuzick J, Sasieni PD, Duffy SW. Impact of Screening on Breast Cancer Mortality: The UK Program 20 Years On. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2016;25(3):455-62. Epub 2015/12/10. doi: 10.1158/1055-9965.Epi-15-0803.

Fracheboud J, de Koning HJ, Boer R, Groenewoud JH, Verbeek AL, Broeders MJ, et al. Nationwide breast cancer screening programme fully implemented in The Netherlands. Breast (Edinburgh, Scotland). 2001;10(1):6-11. Epub 2004/02/18. doi: 10.1054/brst.2000.0212.

Veenhuizen SGA, de Lange SV, Bakker MF, Pijnappel RM, Mann RM, Monninkhof EM, et al. Supplemental Breast MRI for Women with Extremely Dense Breasts: Results of the Second Screening Round of the DENSE Trial. Radiology. 2021;299(2):278-86. Epub 2021/03/17. doi: 10.1148/radiol.2021203633.

Lauby-Secretan B, Scoccianti C, Loomis D, Benbrahim-Tallaa L, Bouvard V, Bianchini F, et al. Breast-cancer screening--viewpoint of the IARC Working Group. The New England journal of medicine. 2015;372(24):2353-8. Epub 2015/06/04. doi: 10.1056/NEJMsr1504363.

Wang J, Greuter MJW, Vermeulen KM, Brokken FB, Dorrius MD, Lu W, et al. Cost-effectiveness of abbreviated-protocol MRI screening for women with mammographically dense breasts in a national breast cancer screening program. Breast (Edinburgh, Scotland). 2022;61:58-65. Epub 2021/12/17. doi: 10.1016/j.breast.2021.12.004.

Hofvind S, Sagstad S, Sebuødegård S, Chen Y, Roman M, Lee CI. Interval Breast Cancer Rates and Histopathologic Tumor Characteristics after False-Positive Findings at Mammography in a Population-based Screening Program. Radiology. 2018;287(1):58-67. Epub 2017/12/15. doi: 10.1148/radiol.2017162159.

Slanetz PJ, Freer PE, Birdwell RL. Breast-density legislation--practical considerations. The New England journal of medicine. 2015;372(7):593-5. Epub 2015/02/12. doi: 10.1056/NEJMp1413728.

Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, et al. Mammographic density and the risk and detection of breast cancer. The New England journal of medicine. 2007;356(3):227-36. Epub 2007/01/19. doi: 10.1056/NEJMoa062790.

McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2006;15(6):1159-69. Epub 2006/06/16. doi: 10.1158/1055-9965.Epi-06-0034.

Nguyen TL, Li S, Dite GS, Aung YK, Evans CF, Trinh HN, et al. Interval breast cancer risk associations with breast density, family history and breast tissue aging. International journal of cancer. 2020;147(2):375-82. Epub 2019/10/15. doi: 10.1002/ijc.32731.

Wanders JO, Holland K, Veldhuis WB, Mann RM, Pijnappel RM, Peeters PH, et al. Volumetric breast density affects performance of digital screening mammography. Breast cancer research and treatment. 2017;162(1):95-103. Epub 2016/12/25. doi: 10.1007/s10549-016-4090-7.

Bakker MF, de Lange SV, Pijnappel RM, Mann RM, Peeters PHM, Monninkhof EM, et al. Supplemental MRI Screening for Women with Extremely Dense Breast Tissue. The New England journal of medicine. 2019;381(22):2091-102. Epub 2019/11/28. doi: 10.1056/NEJMoa1903986.

Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. Jama. 2008;299(18):2151-63. Epub 2008/05/15. doi: 10.1001/jama.299.18.2151.

Nothacker M, Duda V, Hahn M, Warm M, Degenhardt F, Madjar H, et al. Early detection of breast cancer: benefits and risks of supplemental breast ultrasound in asymptomatic women with mammographically dense breast tissue. A systematic review. BMC cancer. 2009;9:335. Epub 2009/09/22. doi: 10.1186/1471-2407-9-335.

Scheel JR, Lee JM, Sprague BL, Lee CI, Lehman CD. Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts. American journal of obstetrics and gynecology. 2015;212(1):9-17. Epub 2014/06/25. doi: 10.1016/j.ajog.2014.06.048.

Hooley RJ, Greenberg KL, Stackhouse RM, Geisel JL, Butler RS, Philpotts LE. Screening US in patients with mammographically dense breasts: initial experience with Connecticut Public Act 09-41. Radiology. 2012;265(1):59-69. Epub 2012/06/23. doi: 10.1148/radiol.12120621.

Weigert J, Steenbergen S. The connecticut experiments second year: ultrasound in the screening of women with dense breasts. The breast journal. 2015;21(2):175-80. Epub 2015/02/17. doi: 10.1111/tbj.12386.

Evans DG, Kesavan N, Lim Y, Gadde S, Hurley E, Massat NJ, et al. MRI breast screening in high-risk women: cancer detection and survival analysis. Breast cancer research and treatment. 2014;145(3):663-72. Epub 2014/04/02. doi: 10.1007/s10549-014-2931-9.

Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. The New England journal of medicine. 2004;351(5):427-37. Epub 2004/07/30. doi: 10.1056/NEJMoa031759.

Morrow M, Waters J, Morris E. MRI for breast cancer screening, diagnosis, and treatment. Lancet (London, England). 2011;378(9805):1804-11. Epub 2011/11/22. doi: 10.1016/s0140-6736(11)61350-0.

Passaperuma K, Warner E, Causer PA, Hill KA, Messner S, Wong JW, et al. Long-term results of screening with magnetic resonance imaging in women with BRCA mutations. British journal of cancer. 2012;107(1):24-30. Epub 2012/05/17. doi: 10.1038/bjc.2012.204.

Saadatmand S, Obdeijn IM, Rutgers EJ, Oosterwijk JC, Tollenaar RA, Woldringh GH, et al. Survival benefit in women with BRCA1 mutation or familial risk in the MRI screening study (MRISC). International journal of cancer. 2015;137(7):1729-38. Epub 2015/03/31. doi: 10.1002/ijc.29534.

Comstock CE, Gatsonis C, Newstead GM, Snyder BS, Gareen IF, Bergin JT, et al. Comparison of Abbreviated Breast MRI vs Digital Breast Tomosynthesis for Breast Cancer Detection Among Women With Dense Breasts Undergoing Screening. Jama. 2020;323(8):746-56. Epub 2020/02/26. doi: 10.1001/jama.2020.0572.

Mann RM, Balleyguier C, Baltzer PA, Bick U, Colin C, Cornford E, et al. Breast MRI: EUSOBI recommendations for women's information. European radiology. 2015;25(12):3669-78. Epub 2015/05/24. doi: 10.1007/s00330-015-3807-z.

Mann RM, Kuhl CK, Kinkel K, Boetes C. Breast MRI: guidelines from the European Society of Breast Imaging. European radiology. 2008;18(7):1307-18. Epub 2008/04/05. doi: 10.1007/s00330-008-0863-7.

Ahmadinejad N, Azhdeh S, Arian A, Eslami B, Mehrabinejad MM. Implementation of abbreviated breast MRI in diagnostic and screening settings. Acta radiologica (Stockholm, Sweden : 1987). 2023;64(3):987-92. Epub 2022/08/09. doi: 10.1177/02841851221114434.

Mango VL, Morris EA, David Dershaw D, Abramson A, Fry C, Moskowitz CS, et al. Abbreviated protocol for breast MRI: are multiple sequences needed for cancer detection? European journal of radiology. 2015;84(1):65-70. Epub 2014/12/03. doi: 10.1016/j.ejrad.2014.10.004.

D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA. ACR BI-RADS Atlas: Breast Imaging Re-porting and Data System Reston, VA, USA: American College of Radiology; 2013 [cited 2013]. Available from: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads.

Niell BL, Freer PE, Weinfurtner RJ, Arleo EK, Drukteinis JS. Screening for Breast Cancer. Radiologic clinics of North America. 2017;55(6):1145-62. Epub 2017/10/11. doi: 10.1016/j.rcl.2017.06.004.

Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. Jama. 2012;307(13):1394-404. Epub 2012/04/05. doi: 10.1001/jama.2012.388.

Kuhl CK, Strobel K, Bieling H, Leutner C, Schild HH, Schrading S. Supplemental Breast MR Imaging Screening of Women with Average Risk of Breast Cancer. Radiology. 2017;283(2):361-70. Epub 2017/02/22. doi: 10.1148/radiol.2016161444.

Emaus MJ, Bakker MF, Peeters PH, Loo CE, Mann RM, de Jong MD, et al. MR Imaging as an Additional Screening Modality for the Detection of Breast Cancer in Women Aged 50-75 Years with Extremely Dense Breasts: The DENSE Trial Study Design. Radiology. 2015;277(2):527-37. Epub 2015/06/26. doi: 10.1148/radiol.2015141827.

Kuhl CK, Schrading S, Strobel K, Schild HH, Hilgers RD, Bieling HB. Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2014;32(22):2304-10. Epub 2014/06/25. doi: 10.1200/jco.2013.52.5386.

Chen SQ, Huang M, Shen YY, Liu CL, Xu CX. Application of Abbreviated Protocol of Magnetic Resonance Imaging for Breast Cancer Screening in Dense Breast Tissue. Academic radiology. 2017;24(3):316-20. Epub 2016/12/06. doi: 10.1016/j.acra.2016.10.003.

Weinstein SP, Korhonen K, Cirelli C, Schnall MD, McDonald ES, Pantel AR, et al. Abbreviated Breast Magnetic Resonance Imaging for Supplemental Screening of Women With Dense Breasts and Average Risk. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2020;38(33):3874-82. Epub 2020/09/16. doi: 10.1200/jco.19.02198.

Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. Jama. 2014;311(24):2499-507.

Kuhl CK. Abbreviated breast MRI for screening women with dense breast: the EA1141 trial. The British journal of radiology. 2018;91(1090):20170441. Epub 2017/07/28. doi: 10.1259/bjr.20170441.

Authors

Arvin Arian
Nasrin Ahmadinejad
Arezoo shafieioun
Bita Eslami
Jaleh Jamshidi
Fahimeh Azizinik
azizinikfahimeh@gmail.com (Primary Contact)
1.
Arian A, Ahmadinejad N, shafieioun A, Eslami B, Jamshidi J, Azizinik F. Added Value of Supplemental Screening Breast MRI in Women at Average or Intermediate Breast Cancer Risk Using Abbreviated Protocols. Arch Breast Cancer [Internet]. 2024 Jan. 31 [cited 2024 Jul. 27];11(1):52-9. Available from: https://archbreastcancer.com/index.php/abc/article/view/805

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