MRI useful in detecting missed breast cancer in high-risk women

In women at high risk for developing breast cancer, MRI is useful in detecting malignant disease that is missed on mammography and physical examination, according to a report in the July 15th issue of Cancer, published online on June 16.

The finding is based on a study of 367 women who had normal mammograms, but underwent MRI screening due to their risk status. The MRI findings were graded on a 5-point scale ranging from 1 (negative) to 5 (highly suggestive of malignancy). The study focused on images rated 3 (probably benign), for which follow-up MRI was recommended.Nearly a quarter (89) of the women had images rated as “probably benign”, lead author Dr. Laura Liberman and colleagues, from the Memorial Sloan-Kettering Cancer Center in New York, observe. Of these women, 70 underwent follow-up MRI at a median of 11 months.Twenty of the women with probably benign findings underwent biopsy either because of disease progression on repeat MRI or for other reasons, the investigators note. Nine of these women (45%) had malignant disease. Of the nine women with breast cancer, five had ductal carcinoma in situ and four had infiltrating ductal cancer. In six of the women, the cancer was non-palpable and mammographically occult.”The findings of the current study indicate the importance of establishing evidence-based criteria for probably benign lesions on breast MRI studies,” the investigators say.”Additional work involving prospective investigation, larger numbers of women, multiple observers using current breast MRI lexicon terminology, feature combinations, quantitative kinetic analysis, and long-term follow-up may be valuable as clinical use of breast MRI continues to evolve,” they add.(Source: Cancer 2003;98: Reuters Health: June 25, 2003: Oncolink)