Study recommends adding MRI to mammo in women with personal history of breast cancer

Screening MRI should be an adjunct to screening mammography in women with a personal history of breast cancer, researchers at the 2010 RSNA scientific assembly in Chicago said.

Currently, the American Cancer Society recommends screening MRI for women who have a genetic or family history of breast cancer. They are at a greater than 20% lifetime risk of contracting breast cancer. However, there has been insufficient evidence to date regarding women with a personal history of treated breast cancer.

In 1025 women undergoing their first screening MR in the five-year study period, researchers found 327 had a genetic family history and 646 had a personal history of breast cancer. The researchers found cancer yield was higher with screening MRI in women with a personal history (3.1%) compared with women with a genetic or family history (1.5%), despite fewer recommendations for biopsy. The findings suggest breast MRI should be added to screening mammography for these women.

In addition, 9.3% of patients with a personal history of breast cancer were recommended for biopsy as opposed to 15% of women with a genetic or family history.

Specificity of screening MRI was also higher in women with a personal history of breast cancer (93.6%) compared with women with a genetic or family history of the disease (86.3%).

Overall sensitivity for the entire study was 92.6%, with two occult cancers detected on MRI.

MRI may be an important adjunct to screening mammography in women with a personal history of breast cancer, said Dr. Wendy Demartini, an assistant professor of breast imaging at the University of Washington in Seattle and presenter of the study.

“Certainly further studies are necessary to clarify its role and, in particular, to identify subgroups most likely to benefit from this tool,” she said. “We hope studies like this will allow us to move into a personalized evidence-based surveillance of women who are breast cancer survivors.”