Last Updated: 2001-07-27 9:46:08 EDT (Reuters Health)
מתוך מדיקונטקסט
By Will Boggs, MD
WESTPORT, CT (Reuters Health) – Magnetic resonance imaging (MRI) is more accurate than mammography in annual breast cancer surveillance of women at high risk of breast cancer, according to a report in the July 18th Journal of the National Cancer Institute.
"The surveillance of women with a strong family history of breast cancer has traditionally been done with mammography as the primary imaging modality," Dr. Mark J. Stoutjesdijk from University Medical Center St. Radboud in Nijmegen, the Netherlands noted in an interview with Reuters Health. But "women who choose surveillance over mastectomy run a higher risk of dying of breast cancer," he said.
Dr. Stoutjesdijk and colleagues, therefore, sought to determine whether MRI could play a role in early detection of breast cancer in women whose lifetime risk of breast cancer exceeded 15% based on family history or the presence of a germline mutation in the BRCA1 or BRCA2 gene.
Thirteen malignant tumors were detected in a group of 179 women, the authors report, all of them imaged by MRI and 12 of them imaged by mammography. The malignancy missed by mammography was a low-grade non-Hodgkin's lymphoma.
MRI yielded no false-negative reports, the report indicates, whereas mammography gave seven false-negative reports, including five radiologist reports of dysplasia.
The AUC (area under the curve), an approximation of the chance that the radiologist correctly identified the presence or absence of malignancy, was significantly higher for MRI than for mammography. The AUC differences persisted after adjustment for age and risk category.
"Our study suggests that tumors can be detected in an earlier stage by MRI than by mammography, which may improve patient survival," Dr. Stoutjesdijk told Reuters Health. "Therefore, MRI should be seriously considered as an addition to the surveillance program of women with a hereditary risk of breast cancer."
Dr. Stoutjesdijk added, "With the data from our study, it is not possible to draw a clear line separating women who should or should not receive MRI. Larger studies, currently in progress, will hopefully enable us to be more specific. Until then, I would add MRI to the surveillance program of women with a lifetime risk of at least 15%, but I would not remove mammography."
J Natl Cancer Inst 2001;93:1095-1102.
-Westport Newsroom 203 319 2700
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